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目的分析湖南省手足口病死亡病例临床与流行病学特点,为防制手足口病、减少手足口病死亡提供科学依据。方法收集2009-2015年湖南省手足口病死亡病例个案信息,采用描述性、分析性流行病学方法分析病例三间分布、临床诊疗特征和病原学特征。结果 2009-2015年,湖南省报告手足口病病死率为0.039%。死亡病例集中出现在4-6月,以农村(77.8%)5岁及以下(99.3%)的散居儿童(87.3%)为主。病例发病到死亡的时间中位数为3 d,初诊为手足口病的正确率为24.3%,主要临床表现为发热(97.1%)、皮疹(83.0%)以及精神差(81.7%),肺水肿为主要并发症(69.6%)。EV71感染占89.8%,不同标本之间肠道病毒阳性率差异无统计学意义(P>0.05)。结论 2009-2015年湖南省手足口病病死率水平较高,死亡病例以农村地区散居儿童为主要人群,病例病情进展迅速,需同时加强乡村医师培训和农村地区家长健康宣传教育以降低病死率。
Objective To analyze the clinical and epidemiological characteristics of HFMD deaths in Hunan Province and provide a scientific basis for preventing hand-foot-mouth disease and reducing the death of hand-foot-mouth disease. Methods The case information of death from hand-foot-mouth disease in Hunan Province from 2009 to 2015 was collected. The distribution, clinical features and etiological features of the cases were analyzed by descriptive and analytical epidemiological methods. Results From 2009 to 2015, Hunan Province reported a fatality rate of 0.039%. The majority of deaths occurred in April-June, mainly in rural areas (77.8%) and children (5 years old and below) (99.3%) (87.3%). The median time from onset to death was 3 days. The correct rate of first diagnosis was hand-foot-mouth disease (24.3%). The main clinical manifestations were fever (97.1%), skin rashes (83.0%) and mental retardation (81.7% The main complication (69.6%). EV71 infection accounted for 89.8%. There was no significant difference in the positive rate of enterovirus between different samples (P> 0.05). Conclusions The mortality rate of hand-foot-mouth disease in Hunan province was relatively high from 2009 to 2015. The deaths were from scattered children in rural areas. The cases progressed rapidly. Rural doctors training and parental health promotion and education in rural areas were also required to reduce the case fatality rate.