儿童重症手足口病危险因素的探讨

目的探讨重症手足口病(HFMD)独立的危险因素,为重症HFMD早期识别和防治提供依据。方法回顾性分析2012年1月至2016年12月252例HFMD患儿的临床资料,按照临床表现分为普通组187例,重症组65例。收集患儿重症诊断指标,进行统计学分析。结果重症组与普通组体温>39%:并>3d、精神差、惊厥、肢体震颤、颈抵抗、呼吸急促、心率增快、高血压、血糖>9mmol/L.外周血白细胞>10×10^9/L.CRP>8mmol/L、胸部X线病变等,比较差异有统计学意义(P<0.05);多因素Logistic回归分析显示:>3d体温>39℃、精神差、肢体震颤、外周血WBO10×10^9/L.血糖>9mmol/L.胸部X线病变为重症儿童HFMD的独立危险因素,具有早期预警作用。结论对具有神经系统症状、精神异常、持续高热的HFMD患儿要高度观注病情的发展,及早制定有效的治疗方案在病情加重早期进行防治。

Objective To investigate the risk factors of hand foot and mouth disease ( HFMD ) independent and provide basis for early identification and prevention of severe HFMD. Methods 252 cases of HFMD children admitted to our hospital from January 2012 to December 2016 were selected, which were divided into the normal group 187 cases and the severe group 65 cases. Using the method of retrospective analysis, the severe diagnosis indexes of the above children were collected and analyzed statistically. Results The number of cases in the severe group and the general group were compared: Above 39X2 and temperature> 3days, poor mental, convulsion, body trembling, neck resistance, shortness of breath and heart rate increase fast, hypertension, blood sugar> 9tendency/L, peripheral blood leukocyte>10 × 10^9/L, CRP>8 tendency for L, chest X-ray lesions and so on, more than two sets of data difierences were statistically significant ( P<0.05 ). The multi-factors Logistic regression analysis showed that the above 39℃ temperature>3days, poor spirit, tremors, peripheral blood WBC>10 × 10^9/L, blood sugar>9 tendency for L, chest X-ray lesions were the independent risk factors for severe HFMD children, and had early warning function. Conclusion The development of HFMD children with neurological symptoms, mental disorders and persistent high fever should be highly monitored, and effective treatment plans should be formulated as soon as possible to prevent and treat HFMD in the early stage of aggravation.