101例手足口病重症病例流行学和临床特征分析

Epidemiological Characteristics and Clinical Study of 101 Severe Cases of Hand, Foot and Mouth Disease

目的分析三年收治手足口病(HFMD)重症病例的流行特征、临床特征和治疗方案,为HFMD重症早期识别和防治提供依据。方法将2015年-2017年本院收治的HFMD重症病例101例纳入分析研究,收集临床资料,对数据进行统计分析。结果男女比1.30:1,年龄以1~2岁年龄组为主,占58.42%,职业分布为以散居儿童为主,占79.21%(80例)。临床特征主要表现为皮疹101例(100%)、持续发热97例(96.04%)和神经系统症状49例(48.51%),循环系统症状不明显。疗程为2~27天,临床用药主要为布洛芬、甲泼尼龙、头孢曲松、阿糖腺苷和热毒宁等退热抗病毒药物,均治愈出院。结论本院HFMD重症病例流行病学特征与我市全人群手足口病流行特征相似。临床表现以皮疹、持续发热、精神差或易惊等神经系统表现为主,重症早期识别应关注上述表现。联合应用退热、激素、抗生素和抗病毒等药物治疗,效果显著。

Objective To analysize the epidemiological characteristics,clinical features and treatment plans of 101 severe cases of hand,foot and mouth disease(HFMD),to provide evidence for early diagnosis,prevention and treatment of HFMD. Methods The incidence and clinical data of severe cases of HFMD in our hospital were collected,and statistical analysis was performed using descriptive analysis.Results From January 2015 to December 2017,101 severe cases of HFMD were treated in our hospital.The male to female ratio was 1.30:1.Majority of the cases was scattered children,which accounted for 79.21%;and distributed in the age group of 1-2 years old,accounting for 58.42%.The clinical features were 101 cases (100%) with rash, 97 cases (96.04%) with fever,49 cases (48.51%) with nervous system manifestation.After 2-27 days of treatment of antipyretics and anti-viral drugs such as ibuprofen,methylprednisolone,ceftriaxone,adenosine triglyceride and redorenin,all cases were healed and discharged.Conclusions The epidemiological characteristics of severe cases of HFMD are similar to those of the whole population.The main clinical manifestations are rash,persistent fever,poor spirit while the symptoms of circulatory system are not obvious.All of manifestations need to be considered in early diagnosis.Combined with antipyretics,hormones, antibiotics and antiviral drugs,the effect is remarkable.