重症手足口病的流行特征分析

Epidemic characteristics of severe hand-foot-mouth disease

目的分析2010年河北省儿童医院住院患儿重症手足口病的流行特征及死亡病例特点,探讨重症手足口病的主要危险因素,为重症手足口病的预防控制提供理论和实践依据。方法使用医院感染监测及数据直报系统开展重症手足口病患儿监测,以2010年1-12月在重症监护病房住院并诊断为重症手足口病患儿为研究对象,采用描述性流行病学方法,对该次疫情的流行特征及死亡病例进行分析。结果重症监护病房共收治重症手足口病患儿419例,危重症患儿36例,死亡18例;发病时间主要在6、7月份,发病例数占全年总数的42.7%;男∶女为1.8∶1;<3岁者367例,占87.6%;重症手足口病患儿肠道病毒71型(EV71)检测阳性率为77.4%;死亡患儿均因并发神经源性肺水肿、肺出血,进而呼吸循环衰竭死亡。结论重症手足口病的发病与年龄、季节以及环境有关,针对性地采取预防措施和及时到定点医院接受规范诊疗,是防止发生重症及死亡的关键。

OBJECTIVE To analyze the epidemic characteristics of hospitalized children with severe hand-foot-mouth disease（severe HFMD） of Children′s Hospital of Hebei Province in 2010 and the death cases,investigate the major risk factors for severe HFMD,so as to provide theoretical and practical bases for prevention and control of severe HFMD.METHODS By the means of hospital infection surveillance and data direct reporting system,the monitoring of the children with severe HFMD were carried out.the patients who were diagnosed with severe HFMD and hospitalized in ICU from Jan to Dec 2010 were selected as study objects;the epidemic characteristics and death cases were analyzed by descriptive epidemiology method.RESULTS There were 419 cases of severe HFMD children,36 cases of critically ill children,18 patients died in the ICU;the onset of the diseases mainly occurred in Jun and Jul,the number of cases during this period accounted for 42.7% in the whole year;the ratio of patients was 1.8∶1 for male/female;there were 367 patients aged less than 3 years,accounting for 87.6%;the positive rate of the detection of EV71 was 77.4% of children with severe HFMD,all the causes for the death cases were due to neurogenic pulmonary edema,and pulmonary hemorrhage,then respiratory and circulatory failure to cause death.CONCLUSION Severe HFMD is associated with the age,season,and environment.It is the key to prevent the severe HFMD and the death through targeted preventive measures and standardized diagnosis and treatment in designated hospital.