论文部分内容阅读
目的分析海南省2009-2010年手足口病死亡病例流行病学特征,为下一步手足口病重症病例防控工作提供科学依据。方法对死亡病例进行个案调查,收集流行病学、临床表现、诊治过程、实验室检测等资料,进行描述性分析。结果 2009年全省累计报告手足口病11 845例,其中死亡病例11例,病死率0.93‰;2010年全省累计报告手足口病25 142例,其中死亡病例5例,病死率0.19‰。16例死亡病例主要分布在乡镇、农村,均为散居儿童,年龄均在3岁及以下。早期临床表现多为先发热,后出疹,病情进展迅速,最终因呼吸、循环衰竭而死亡,发病至死亡平均间隔3.2天。14例病例首诊单位为县级及以下医疗机构,早期诊出率低(21.43%)。县级医院手足口病危重病例抢救成功率低(0/15)。12例病例经实验室检测,EV71阳性8例(占实验室阳性比例为88.89%)。结论手足口病重症病例防控重点人群仍为3岁以下儿童。县级医院是手足口病重症病例防控工作中的一道重要关卡。应加强对县级医院重症救治的支持,强化危重症早期识别和救治能力的培训,做到早期识别、有效抢救,降低海南省手足口病重症病例死亡率。
Objective To analyze the epidemiological characteristics of HFMD death from 2009 to 2010 in Hainan Province and provide a scientific basis for prevention and control of HFMD in the next step. Methods The death cases were investigated by case study, and the epidemiology, clinical manifestations, diagnosis and treatment process, laboratory tests and other data were collected for descriptive analysis. Results In 2009, a total of 11 845 hand-foot-mouth disease cases were reported in the province, including 11 deaths and a case-fatality rate of 0.93 ‰. In 2010, 25 142 hand-foot-mouth disease cases were reported in the province, including 5 deaths and a case fatality rate of 0.19 ‰. 16 cases of deaths are mainly distributed in towns and villages, are scattered children, all under 3 years old and below. Early clinical manifestations and more for the first fever, rash, the rapid progress of the disease, and ultimately death due to respiratory, circulatory failure, the average mortality to death 3.2 days. The first case of 14 cases was a medical institution at or below the county level with a low rate of early diagnosis (21.43%). County-level hospital hand-foot-mouth disease critically ill rescue success rate is low (0/15). 12 cases of laboratory tests, EV71 positive in 8 cases (accounting for laboratory positive ratio was 88.89%). Conclusion HFMD patients are still under 3 years old. County-level hospitals are an important barrier in the prevention and control of HFMD cases. We should strengthen the county hospital-based critical care support, and strengthen the early diagnosis and treatment of critically ill patients with the ability to training, so that early identification and effective rescue and reduce the incidence of severe hand-foot-mouth disease in Hainan Province mortality.