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目的分析广东省深圳市宝安区确诊的78例重症手足口病病例的流行特征,探讨重症手足口病临床表现、就诊过程及重症发生的危险因素,为临床及时发现手足口病病情改变、提高基层医院对手足口病的诊断能力、进行流行病学调查制定重症手足口病防控策略提供依据。方法回顾性分析深圳市宝安区2009~2010年确诊的78例重症手足口病病例的流行特征及临床表现,采用描述性流行病学方法对结果进行分析。结果 2009~2010年深圳市宝安区共报告重症手足口病病例78例,其中男35例、女43例;发病年龄最大7岁,最小2个月,患者以0~3岁儿童为主,共报告65例,占重症病例总数的83.33%;发病以散居儿童为主,其次是托幼儿童;病例报告最多的为观澜街道,报告15例,占总数的19.23%;死亡9例,均为3岁以下儿童,男5例,女4例;死亡病例较多的为观澜街道,共报告3例,占死亡病例总数的33.33%;病例多发生于夏季和秋季,于6、8、11月份各出现一个高峰;14例有明确手足口病病例的接触史;48例采集便样标本进行实验室检测,结果阳性45例,标本阳性检出率为93.75%,EV71检测阳性率为89.58%;农村及城乡结合部病例居多;重症病人临床以高热、多发皮疹及多系统损害最为常见。结论重症手足口病病情发展迅速,应将提高基层医院对手足口病的诊断能力和及时治疗、及时发现病情改变作为防治重点;加强宣传教育,让群众对该病均能有所认识,提高识别疾病能力及就诊意识。
Objective To analyze the epidemiological characteristics of 78 severe HFMD cases diagnosed in Baoan District, Shenzhen City, Guangdong Province, and to explore the clinical manifestations, treatment process and risk factors of severe HFMD. To find out the clinical changes of HFMD in clinic and improve the quality of HFMD patients Hospital opponents foot and mouth disease diagnostic capabilities, epidemiological investigation to develop prevention and control measures of severe hand, foot and mouth disease provide the basis. Methods The epidemiological characteristics and clinical manifestations of 78 cases of severe HFMD confirmed from 2009 to 2010 in Bao’an District of Shenzhen City were retrospectively analyzed. The results were analyzed by descriptive epidemiological method. Results A total of 78 cases of severe hand-foot-mouth disease were reported in Baoan District of Shenzhen City from 2009 to 2010, including 35 males and 43 females, with a maximum age of 7 years and a minimum of 2 months. The patients were mainly children aged 0-3 years. Reported 65 cases, accounting for 83.33% of the total number of severe cases; the incidence of diaspora mainly followed by kindergarten children; the highest case reports for the Mission Hills streets, reports of 15 cases, accounting for 19.23% of the total; 9 cases of death were 3 There were 5 males and 4 females aged less than 4 years. Three deaths were reported in Guanlan Street, accounting for 33.33% of the total deaths. Cases occurred mostly in summer and autumn, and in June, August and November each A case of HFMD occurred in 14 cases, and a history of exposure to hand-foot-mouth disease was found in 14 cases. Forty-eight samples were collected for laboratory tests. The positive results were found in 45 cases. The positive rate was 93.75% And the majority of urban and rural areas with cases; critically ill patients with clinical fever, multiple rashes and multiple system damage is the most common. Conclusions Severe HFMD develops rapidly and the diagnosis ability and timely treatment of HFMD in primary hospitals should be improved. Disease changes should be timely detected as the focus of prevention and treatment. Public awareness and education should be strengthened so that people can understand the disease and improve their recognition Disease ability and consultation awareness.