麻疹患儿肠道排毒观察及预防对策

目的 对麻疹住院患儿,观察其肠道病毒排毒情况,为麻疹临床诊断提供参考,同时为麻疹的传播、防控工作提供依据.方法 对2011年3月至2014年6月住院临床诊断麻疹的161例患儿,在入院2d内同时采集咽拭子和粪便标本,标本在冷链条件下送传染病诊治国家重点实验室荧光定量RT-PCR检测麻疹病毒核酸.结果 161例麻疹患儿粪便麻疹病毒核酸阳性159例占98.8%,咽拭子病毒核酸阳性155例占96.3%.粪便标本检测麻疹病毒核酸高于咽拭子病毒核酸及血清麻疹特异性IgM抗体阳性率,但差异无统计学意义（P〉0.05）.结论 麻疹患儿肠道病毒检出率高,可能存在消化道传播风险,对麻疹患儿除呼吸道传播防控措施外,还应做好进行消化道传播防控措施和护理干预,有利于控制麻疹的传播和交叉感染.

Objective To observe the intestinal virus detoxification of hospitalized children with measles,to provide reference for clinical diagnosis of measles,and to provide the basis for the spread of measles,prevention and control work. Methods From March 2011 to April 2014 in Hangzhou city children＆#39;s Hospital of infectious diseases hospital clinical diagnosis for 161 patients with measles,in admission within 2 days and collection of throat swabs and stool specimens,specimens in the cold chain conditions send infectious disease state key laboratory for diagnosis and treatment of fluorescent quantitative RT-PCR detection of measles virus RNA. Results 161 cases of measles in the faeces from children with measles virus RNA were positive in 159 cases accounted for 98.8%,pharyngeal swab viral nucleic acid was positive in 155 cases accounted for 96.3%. Stool specimens for detection of measles virus nucleic acid were higher than those of throat swab viral nucleic acid and serum measles specific IgM antibody positive rate,but no statistical difference. To say the least fecal specimens for detection of measles virus RNA and pharyngeal swabs and serum samples had the same clinical significance,the stool in measles virus content was very high,as respiratory infectious diseases measles,measles virus still after intestinal excretion,with intestinal spread the risk. Conclusion Children with measles enterovirus detection rate is high,of children with measles in addition to the spread of respiratory tract control measures,should also do a good job in the digestive tract to prevent and control the spread of measures and nursing intervention,is conducive to the spread of measles control and cross infection.