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目的比较2009年开封市手足口病流行中轻症和重症患儿临床特征的差异,早期识别重症患儿。方法随机选择开封市102例手足口病病例开展病案和电话调查,了解患者的一般情况,临床表现、体征与辅助检查结果。结果重症体温峰值高于轻症(t=3.86,P<0.05),两者发热持续时间差异具有统计学意义(Z=5.88,P=0.000)。轻症病例均有出疹,1例EV71重症病例为不典型出疹,部位为耳后、前胸,1例EV71重症病例没有出疹。轻症23.29%出现精神差,其次为咳嗽占16.44%,两症状出现时间中位数均为第1 d。重症75.86%出现精神差,其次为惊颤占58.62%,呕吐55.17%,三症状出现时间中位数均为第3 d。结论手足口病多以发热、出疹为首发症状,出疹部位以手足口3部位同时出疹为主,疹型以疱疹多见。重症发热时间较长,体温峰值高于轻症,精神差、惊颤、呕吐等症状多见,大多合并有病毒性脑炎、支气管炎等。
Objective To compare the clinical features of children with mild and severe cases of hand-foot-mouth disease in Kaifeng City in 2009 and to identify early severe children. Methods A total of 102 cases of HFMD in Kaifeng City were randomly selected to carry out medical records and telephone surveys to understand the general condition, clinical manifestations, signs and auxiliary examination results. Results The peak of severe body temperature was higher than that of mild (t = 3.86, P <0.05). There was significant difference in the duration of fever between the two groups (Z = 5.88, P = 0.000). In mild cases, rash occurred. One case of severe EV71 was atypical rash and the other part was ear. The frontal chest and 1 case of severe EV71 did not have rash. Mild 23.29% mild mental illness, followed by cough accounted for 16.44%, the median time of onset of both symptoms are the first day. Severe 75.86% of the patients showed poor psychosis, followed by 58.62% of patients with asthma and 55.17% of patients with vomiting. The median time to symptom onset was 3 days. Conclusion Hand, foot and mouth disease mostly fever, rash as the first symptom, rash site with hand, foot and mouth 3 parts at the same time rash, rash with herpes more common. Severe fever longer, body temperature peak higher than mild, poor spirit, symptoms such as chafing and vomiting more common, most of the merger with viral encephalitis, bronchitis and so on.