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目的总结2014年初濮阳地区手足口病流行特点;手足口病的病原学特点、皮疹特点和临床分型之间可能的关系。为手足口病的临床诊疗提供依据。方法 2013年12月1日至2014年3月31日在濮阳市人民医院感染性疾病科住院的210例手足口病患儿为研究对象。总结分析其临床表现、病毒学检查结果、皮疹特点并总结分为典型皮疹和不典型皮疹,分析其中存在的关系及结果。结果 210例手足口病住院患儿,年龄5个月~8岁。其中小于3岁者193例,3岁~8岁17例。普通手足口病150例,病原体检测阳性121例,占80.66%,其中肠道病毒EV71型(以后简称EV71)阳性10例,占6.66%,柯萨奇阳性(以后简称CA16)107例,占71.33%,其他肠道病毒4例,占2.66%。重症手足口病60例,病原体检测阳性51例,占85.00%,其中EV71阳性39例,占76.47%,CA16阳性10例,占19.60%,其他肠道病毒2例,占3.92%。117例CA16阳性患儿中,普通病例为107例,典型皮疹为98例,占普通病例91.58%,不典型皮疹9例,占普通病例8.41%。重症病例10例,典型皮疹6例,不典型皮疹4例。49例EV71阳性患者中,重症病例39例,典型皮疹4例,占重症病例10.25%,不典型皮疹患者35例,占重症病例89.74%。普通病例10例,典型皮疹3例,不典型皮疹7例。结论 2014年初濮阳地区手足口病患儿以CA16感染为主,但重症病例以EV71型为主。EV71型感染患者皮疹多不典型,而CA16型感染患者多为典型疱疹。重症病例及时住院早期干预提高救治成功率。
Objective To summarize the epidemiological characteristics of HFMD in Puyang area in early 2014. The possible relationship between HFMD features and clinical features of HFMD was analyzed. Hand-foot-mouth disease clinical diagnosis provide the basis. Methods From December 1, 2013 to March 31, 2014, 210 HFMD children hospitalized in Infectious Diseases Department of Puyang People’s Hospital were studied. Summarized and analyzed its clinical manifestations, virological test results, rash characteristics and summarized as a typical rash and atypical rash, analysis of the relationship and the results there. Results 210 cases of hand, foot and mouth disease hospitalized children, aged 5 months to 8 years. Among them, 193 cases were less than 3 years old and 17 cases were from 3 years old to 8 years old. There were 150 cases of common hand-foot-mouth disease and 121 cases were positive for pathogen detection, accounting for 80.66%. Among them, 10 cases were EV71 positive (6.6%), 107 cases were Coxsackie positive (CA16) %, Other enterovirus in 4 cases, accounting for 2.66%. There were 60 cases of severe hand-foot-mouth disease and 51 cases of pathogen positive test, accounting for 85.00%. Among them, 39 cases were positive for EV71, accounting for 76.47%, 10 cases were positive for CA16, accounting for 19.60%, 2 cases were other enteroviruses accounting for 3.92%. In 117 cases of CA16-positive children, there were 107 common cases, 98 typical rashes, accounting for 91.58% of common cases and 9 atypical rashes, accounting for 8.41% of common cases. 10 cases of severe cases, 6 cases of typical rash, 4 cases of atypical rash. Of the 49 EV71 positive patients, 39 were severe cases, 4 were typical rashes, 10.25% were severe cases, 35 were atypical rashes, and 89.74% were severe cases. 10 cases of common cases, 3 cases of typical rash, atypical rash in 7 cases. Conclusion In early 2014, children with HFMD in Puyang mainly had CA16 infection, but severe cases were predominantly EV71. Patients with EV71 infection are often atypical rashes, and most patients with CA16 infection are typically herpes. Severe cases promptly hospitalized early intervention to improve the success rate of treatment.