本文選題：手足口病　切入點：流行病學特征　出處：《中南大學》2013年碩士論文

【摘要】：目的：1.了解張家界市2008-2012年手足口病發(fā)病情況；2.分析手足口病時間、地區(qū)、人群三間分布及病原學構成特征；3.分析張家界市手足口病重癥病例的臨床表現特征；4.為制定張家界手足口病防控策略提出針對性建議。 方法：進入國家疾病監(jiān)測信息系統(tǒng),按現住地址、發(fā)病日期導出2008-2012年的張家界市手足口病病例資料,對張家界市手足口病發(fā)病率、死亡率及流行病學分布特征進行統(tǒng)計分析。對所有重癥和死亡病例進行用《手足口病預防控制指南》(2009版)的調查表進行流行病學調查,對其發(fā)病的臨床特征進行分析。同時收集市疾控中心實驗室對各區(qū)縣送檢的部分手足口病患者糞便、咽拭子標本的檢測結果,分析張家界市手足口病的病原學特征。 結果：1.2008至2012年張家界市共報告手足口病例4975例,其中重癥病例19例(包括死亡病例4例)。分年度發(fā)病數分別為154例、177例、1501例、490例、2653例；分年度發(fā)病率分別為：10.33/10萬、11.85/10萬、100.27/10萬、33.19/10萬、178.72/10萬。4975例手足口病例中臨床診斷4716例,占94.79%；實驗室確診259例,占5.21%。 2.張家界市手足口病患者的發(fā)病年齡主要為1-4歲嬰幼兒。2008至2012年1-4歲嬰幼兒分別占該年HFMD報告病例數的79.87%、81.92%、79.95%、78.98%、75.31%。男性發(fā)病多于女性,2008至2012年手足口病男女發(fā)病數相對比最高2.4：1,最低1.73：1。病例類型以散居兒童(76.98%)為主,其次為托幼兒童(19.30%)；聚集疫情76.19%發(fā)生在散居兒童。 3.各月均有病例報告,但每年春夏之間的4-7月及冬季11月為發(fā)病高峰,2008-2012年4-7月手足口病發(fā)病人數占當年手足口病例總數的比例分別為25.32%、51.41%、49.83%、39.80%、62.53%；轄區(qū)內四個區(qū)縣均有手足口病例報告,以兩區(qū)(永定區(qū)、武陵源區(qū))為高發(fā)地區(qū)。 4.張家界市手足口病病原譜以EV71為主,占陽性標本的52.83%,是引起張家界市手足口病暴發(fā)流行的主要病原體。2010-2012年病原體為EV71的手足口病病例占本年實驗室檢測病例數的比例分別為30.77%、48.72%、84.34%。 5.手足口病重癥病例的主要神經系統(tǒng)癥狀為精神差、煩躁不安、易驚、頭痛、嗜睡、抽搐、手足抖動等；主要呼吸系統(tǒng)癥狀為呼吸急促、呼吸困難、口唇紫紺、咽痛、咳嗽等；主要循環(huán)系統(tǒng)癥狀為心率加快、心跳節(jié)律改變、皮膚顏色異常、指、趾或口唇發(fā)紺等。 結論：2008至2012年張家界市累計報告手足口病例4975例,其中重癥病例19例,死亡4例；病例以1-4歲低年齡組兒童為主,病例類型主要為散發(fā)兒童,以每年4-7月和11月為高發(fā)期,以永定區(qū)和武陵源區(qū)為高發(fā)地區(qū)；EV71是導致張家界市手足口病發(fā)生及重癥的主要病原體；手足口病重癥病例的主要臨床表現為頭痛、精神差、易驚、呼吸急促、呼吸困難、心率加快、心跳節(jié)律改變等。
[Abstract]:Objective to understand the incidence of hand-foot-mouth disease in Zhangjiajie from 2008 to 2012. To analyze the time and area of hand-foot-mouth disease, Analysis of the clinical manifestations of severe hand-foot-mouth disease cases in Zhangjiajie City. 4. Suggestions for formulating prevention and control strategies of hand-foot-mouth disease in Zhangjiajie. Methods: the data of hand, foot and mouth disease cases in Zhangjiajie City from 2008 to 2012 were derived according to the current address and date of onset, and the incidence of hand foot and mouth disease in Zhangjiajie City was analyzed. The mortality and epidemiological distribution characteristics were statistically analyzed. All severe and fatal cases were investigated with the questionnaire of the guidelines for the Prevention and Control of hand, foot and mouth Disease (2009 edition). The clinical characteristics of the disease were analyzed, and the results of feces and throat swabs of some hand-foot-mouth disease patients were collected in the laboratory of the Center for Disease Control and Prevention, and the etiological characteristics of hand-foot-mouth disease in Zhangjiajie were analyzed. Results 1. From 2008 to 2012, 4975 cases of hand, foot and mouth disease were reported in Zhangjiajie, including 19 cases of severe disease (including 4 cases of death). The annual incidence of HFMD was 100.27 / 100.27 / 100.27 / 100.27 / 100.27 / 100.75 cases of hand-foot-mouth disease, respectively: 4716 cases (94.79%) were clinically diagnosed, and 259 cases (5.21%) were confirmed in the laboratory, out of 178.72% .4975 cases of hand, foot and mouth disease. 2. The onset age of HFMD patients in Zhangjiajie City is mainly 1-4 years old infants and infants aged 1-4 years. From 2008 to 2012, infants aged 1-4 years accounted for 79.87% of the reported cases of HFMD in that year, respectively. 79.959.95% 78.98% of the total incidence of HFMD patients was 75.31%. The incidence of hand-foot-mouth disease in men was higher than that in women from 2008 to 2012. The incidence of hand-foot-mouth disease in men was higher than that in women from 2008 to 2012. The highest is 2.4: 1, and the lowest is 1.73: 1.The type of case is mainly scattered children (76.98). The incidence of agglomeration was 76.19% among scattered children. 3. Cases of HFMD were reported every month, but the number of HFMD cases accounted for 25.32% of the total number of HFMD cases in that year between April to July 2008 and November of winter in November of winter were 25.32% of the total number of HFMD cases in that year, respectively. The proportion of HFMD cases reported in each of the four districts and counties in the jurisdiction was 62.53. Two districts (Yongding District, Wulingyuan District) for the high incidence area. 4. EV71 is the main pathogenic spectrum of hand-foot-mouth disease in Zhangjiajie city, accounting for 52.83% of positive specimens. It is the main pathogen causing HFMD outbreak in Zhangjiajie City. The proportion of HFMD cases with EV71 in 2010 to 2012 is 30.77 ~ 48.722% and 84.34% respectively. 5. The main nervous system symptoms of severe hand, foot and mouth disease cases were mental retardation, agitation, agitation, agitation, headache, drowsiness, convulsion, shaking of hand and foot, and the main respiratory system symptoms were shortness of breath, dyspnea, cyanosis of lips, sore throat, cough and so on. The main symptoms of circulatory system are heart rate acceleration, heart rhythm change, skin color abnormality, finger, toe or lip cyanosis, etc. Conclusion from 2008 to 2012, 4975 cases of hand-foot-mouth disease were reported in Zhangjiajie City, including 19 cases of severe disease and 4 cases of death. Taking Yongding District and Wulingyuan District as high incidence areas, EV71 is the main pathogen leading to the occurrence and severity of hand, foot and mouth disease in Zhangjiajie City, and the main clinical manifestations of severe cases of hand foot and mouth disease are headache, poor spirit, easy to panic, shortness of breath and difficulty in breathing. The heart rate quickens, the heartbeat rhythm changes, etc.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R181.3;R512.5

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