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目的探讨重庆市儿童重症手足口病病例的影响因素,为今后征对性开展干预工作,降低手足口病重症病例的发病率和病死率提供参考。方法收集2011年-2014年重庆市90例重症手足口病和90例轻症手足口病病例,以轻症病例为对照组,重症病例为病例组,进行重症病例的危险因素研究分析。采用统一调查表进行调查,资料应用Epi Data 3.1软件建立数据库,使用SPSS 13.0软件进行单因素和多因素非条件logistic回归分析。结果单因素分析发现病毒类型、户口类型、现住址类型、照看人文化程度、发病季节、是否发热、是否出疹、初次就诊医院类型、初诊是否确诊手足口病等14个因素为重症手足口病的影响因素(P<0.05)。多因素分析结果显示,现住地类型为农村[OR=27.29,95%CI(3.71,200.72)]、首次就诊未确诊手足口病[OR=141.03,95%CI(12.43,1 599.70)]、感染病毒类型为肠道病毒71型[OR=244.32,95%CI(18.99,3 143.74)]为重症病例的危险因素。结论应针对重症手足口病的危险因素开展主动监测,同时积极采取有效的预防措施,及时对重症患儿进行对症治疗,有助于降低重症手足口病病例的发病率和病死率。
Objective To explore the influencing factors of severe hand-foot-mouth disease (CHD) in children in Chongqing and to provide reference for the intervention in the future and to reduce the morbidity and mortality of HFMD cases. Methods Ninety cases of severe hand-foot-mouth disease and 90 cases of mild hand-foot-mouth disease in Chongqing from 2011 to 2014 were collected. The mild cases were taken as the control group, the severe cases were case groups, and the risk factors of severe cases were analyzed. A unified questionnaire was used to investigate. The data were analyzed by using Epi Data 3.1 software and SPSS 13.0 software for univariate and multivariate non-conditional logistic regression analysis. Results Univariate analysis found 14 factors including type of virus, type of household registration, type of living address, level of caregiver, season of onset, fever, rash, initial hospital type, first diagnosed hand-foot-mouth disease, etc. were severe HFMD (P <0.05). The results of multivariate analysis showed that the type of current residence was rural [OR = 27.29,95% CI (3.71,200.72)], the first diagnosis of undiagnosed HFMD [OR = 141.03, 95% CI 12.43,1 599.70] The type of virus was enterovirus 71 [OR = 244.32,95% CI (18.99,3143.74)] was a risk factor for severe cases. Conclusions Active monitoring should be carried out on the risk factors of HFMD. At the same time, active preventive measures should be actively taken to treat the symptomatic treatment of critically ill children. It is helpful to reduce the morbidity and mortality of HFMD cases.