广东省手足口病确诊病例发病及诊疗情况调查

The clinic characteristics and hospital visiting activity of hand,foot and mouth disease cases in Guangdong Province

目的了解广东省2008年4—5月手足口病确诊病例的临床表现、病程、就诊行为等。方法采用统一设计的调查表，电话调查网络报告的2008年4月24日至5月14日发病的实验室确诊手足口病非死亡病例的家长。调查内容包括患者一般情况、发病及就诊情况、临床情况等。结果共调查115例确诊手足口病非死亡病例，其中EV71感染所占比例最高，占65．2％，CoxA16占15．7％，其他肠道病毒占19．1％。就诊1次、2次、3次及以上的分别为30．4％、45．2％、24．3％；66．1％的病例住院；住院时间以4～7d的为多，占61．8％，其中EV71感染者住院时间最长；病程在4～10d的占75．6％，其中CoxA16感染者病程最长。自述发热的77例（67．0％）；出疹的115例（100．0％），出疹部位主要在手掌（94例，81．7％），足掌（84例，73．0％），口腔（89例，77．4％）和臀部（42例，36．5％）。在手、足、口3个部位中，任1处出疹的113例（98．3％），任2处出疹的92例（80．0％），3个部位都出疹的62例（53．9％）。不同毒株感染者的发热与否和出疹部位多少的差别无统计学意义（P〉0．05）。115例病例中自述症状符合《手足口病预防控制指南（2008年版）》病例定义的占66．1％。结论2008年4—5月广东省手足口病以EV71感染为主。不同肠道病毒血清型所致手足口病的发热和出疹症状大致相同。我国的手足口病诊断标准有待进一步规范。

Objective To study the clinic characteristics and hospital visiting activity of hand, foot and mouth disease （HFMD） in children in Guangdong Province in 2008. Methods The data were collected by telephone - survey and descriptively analyzed. Results Of 115 surveyed HFMD cases, 65.2% were caused by EV 71, 15.7% by CoxA 16, and 19.1% by other EV virus. 30.4% cases visited clinic 1 time, 45.2% visited 2 times, and 24.3% visited more than 3 times. 66.1% cases were inpatient. Length of hospitalization ranged from 4 to 7 days in 61.8% of inpatients. 75.6% cases＇duration raged from 4 to 10 days. Fever occurred in 77 patient（67.0% ）. Rashes were observed in all 115 patients, of whom, 81.7% occurred on hand, 73.0% on foot, 77.4% in mouth, and 36.5% on hip. Conclusion HFMD occurring in Guangdong from April to May ,2008 were mainly caused by EV 71. The symptoms of fever and rash are similar to the cases of HFMD caused by enteric viruses with different serotypes. The current diagnosis guideline was less practical.