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目的了解广东省2008年4-5月手足口病确诊病例的临床表现、病程、就诊行为等。方法采用统一设计的调查表,电话调查网络报告的2008年4月24日至5月14日发病的实验室确诊手足口病非死亡病例的家长。调查内容包括患者一般情况、发病及就诊情况、临床情况等。结果共调查115例确诊手足口病非死亡病例,其中EV 71感染所占比例最高,占65.2%,CoxA 16占15.7%,其他肠道病毒占19.1%。就诊1次、2次、3次及以上的分别为30.4%、45.2%、24.3%;66.1%的病例住院;住院时间以4~7d的为多,占61.8%,其中EV 71感染者住院时间最长;病程在4~10 d的占75.6%,其中CoxA 16感染者病程最长。自述发热的77例(67.0%);出疹的115例(100.0%),出疹部位主要在手掌(94例,81.7%),足掌(84例,73.0%),口腔(89例,77.4%)和臀部(42例,36.5%)。在手、足、口3个部位中,任1处出疹的113例(98.3%),任2处出疹的92例(80.0%),3个部位都出疹的62例(53.9%)。不同毒株感染者的发热与否和出疹部位多少的差别无统计学意义(P>0.05)。115例病例中自述症状符合《手足口病预防控制指南(2008年版)》病例定义的占66.1%。结论2008年4-5月广东省手足口病以EV 71感染为主。不同肠道病毒血清型所致手足口病的发热和出疹症状大致相同。我国的手足口病诊断标准有待进一步规范。
Objective To understand the clinical manifestations, course of disease and medical treatment of hand-foot-mouth disease diagnosed in April-May 2008 in Guangdong Province. Methods Using a uniformly designed questionnaire, the telephone survey network reported parents of non-death cases of hand-foot-mouth disease diagnosed in the laboratory from April 24 to May 14, 2008. Survey includes the general situation of patients, incidence and treatment, clinical conditions. Results A total of 115 non-death cases of HFMD were investigated. Among them, EV 71 infection accounted for the highest proportion (65.2%), CoxA 16 (15.7%) and other enteroviruses (19.1%). The first, second, third and more visits were 30.4%, 45.2% and 24.3% respectively; 66.1% of the cases were hospitalized; the length of hospitalization was 4 ~ 7 days, accounting for 61.8% The longest; duration of 4 ~ 10 d accounted for 75.6%, of which CoxA 16 infected the longest course. There were 77 cases (67.0%) with fever, 115 cases (100.0%) with rash, and 77 cases (77.4%) with palpation (84 cases, 73.7% %) And buttocks (42 cases, 36.5%). 113 cases (98.3%) had rash in any one of the three parts of hand, foot and mouth, 92 cases (80.0%) had rash in 2 cases, 62 cases (53.9%) had rash in 3 parts, . There was no significant difference between fever and rash in different strains of infected patients (P> 0.05). In 115 cases, self-reported symptoms met the definition of case definition of Hand Foot and Mouth Disease Prevention and Control Guideline (2008 Edition), accounting for 66.1%. Conclusion From April to May 2008, EV71 infection was the most common HFMD in Guangdong Province. Fever and rash symptoms of HFMD caused by different enterovirus serotypes are roughly the same. China’s hand, foot and mouth disease diagnostic criteria need to be further standardized.