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目的探讨重症手足口病临床表现、就诊过程及重症发生可能因素。方法回顾性分析包头市2010年确诊的29例重症手足口病病例的流行特征及临床表现。结果 51.72%的病例接触手足口病病人后发病,农村及城乡结合部居住者居多,重症病人临床以高热、多发皮疹及多系统损害常见(93%)。多见精神差、食欲不振、呕吐,心率改变、脑膜刺激征;常并发病毒性脑炎和心肌炎;重症病例首诊确诊率低,转诊多,所需确诊时间长;基层医院手足口病确诊率低。结论农村、城乡结合处依然是手足口病防控的薄弱环节和重点,及时发现病情的改变、提高基层医院对手足口病的诊断能力,是提高疾病及时治疗、控制传染源、减少病死率的关键。
Objective To explore the clinical manifestations of severe HFMD, the course of treatment and the possible causes of severe disease. Methods A retrospective analysis of Baotou in 2010 confirmed 29 cases of severe HFMD cases of epidemiological characteristics and clinical manifestations. Results 51.72% of the cases came into contact with hand-foot-mouth disease, and most of them lived in rural and urban-rural areas. High-fever, multiple rash and multiple system injuries were common in critically ill patients (93%). More common mental retardation, loss of appetite, vomiting, heart rate changes, meningeal irritation; often complicated by viral encephalitis and myocarditis; first diagnosis of critically ill patients with low diagnosis, referral and more, the required long diagnosis; hand-foot-and-mouth disease in primary hospital diagnosis Low rate. Conclusion The combination of rural and urban areas is still the weakest link in prevention and control of HFMD. Timely detection of changes in disease and improvement of diagnosis of hand-foot-mouth disease in grass-roots hospitals is to improve the timely treatment of diseases, control the source of infection and reduce the mortality rate The essential.