儿童麻疹89例临床调查分析

Clinical investigation and analysis of treatment of measles in children

目的:探讨小儿麻疹有效的干预措施及规范的治疗手段。方法:回顾性分析2007年1月～2008年1月收住院的89例小儿麻疹的临床资料,包括观察时段住院患者的流行病学特征、发病特点、诊治经过等。结果:本组流动人口占44.94%(40/89);年龄组以3岁以下的嬰幼儿为主,占71.91%(64/89),其中8月龄～3岁占56.18%(50/89);符合麻疹计划免疫接种条件75例,接种率为26.67%(20/75),流动人口接种率为7.5%(3/40);74.39%(61/82)病例发病前均有多家医院就诊史,临床特点:热程长,体温高峰较高,出疹期时间延长,并发症较多(小年龄组尤其明显);并发症仍以肺炎、肠炎为主;死亡1例,死亡率为1.12%(1/89);院外未频繁使用退热药组和频繁使用退热药组的出疹期和热程比较有显著性差异,P<0.05;本组50例诊断为肺炎或支气管炎,40%淋巴细胞绝对值减少。结论:麻疹疫苗强化免疫及防止医源性传播应作为控制麻疹流行的重要措施,抗菌及退热药物的合理使用亟待规范。

Objective： To investigate the treatment and prevention of measles in children. Methods： Clinical data of 89 children patients with measles treated in our department between January 2007 - January 2008 were analysed retrospectively, including epidemiologieal characteristics, characteristics of the disease, and diagnosis and treatment. Results： Of the patients, 44.94% （40/89） were migrating population, 71.91% （64/89） were below 3 years of age, including 56.18% （50/89） patients of 8 months to 3 years of age; 26.67% （20/75） of 75 patients targeted for planned immunity had undergone the planned immunity; vaccination rate in migrating population was 7.5% （3 / 40） ; 74.39% （61/82） patients had history of referring to several hospitals prior to establishment of diagnosis. Clinical features of measles in infants and children ： time of fever was long, peak temperature of the fever was high, rash onset time long, more complications （ especially to the younger infants and children） ; the main complications were pneumonia and enteritis; one patients died with death rate of 1.12% （1/89） ;compared the patients treated with antipyretics frequently and less frequently prior to hospitalization, the time of rashing and phase of fever had significant difference between the different treatment before hospitalization （ P 〈 0. 05 ） ; 50 patients were diagnosed as pneumonia or bronchitis, 40% with reduction in absolute lymphocyte. Conclusion ： Intensive immunization of vaccination and prevention of iatrogenic spread are important measures to prevent and control of measles; it＇s urgent to take rational use of anti-bacterial and antipyretic drugs.