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[目的]探索手足口病重症病例危险因素、分析死亡病例特征。[方法]对河南省东部地区2009年春季手足口病131例普通及重症病例、16例死亡病例进行个案调查,收集信息并建立数据库,通过SPSS15.0软件进行Logistic回归单因素与多因素分析,对重症病例可能危险因素进行探索。对16例死亡病例信息进行统计描述。[结果]单因素分析中出疹部位(OR=1.422)、病前与其玩耍孩子发病数(OR=1.455)及先后就诊医疗机构数(OR=2.606)这3个因素为重症可能危险因素;多因素分析只有先后就诊医疗机构数(P=0.007)1个变量有统计学意义,其OR=2.567。死亡病例首诊地点多为村级卫生所,诊断不及时,就医环节多,入院后救治积极但效果不佳。[结论]先后就诊医疗机构数是重症危险因素,出疹部位、患儿病前与其玩耍孩子发病数是重症可能危险因素。减少手足口病死亡病例发生的关键是首诊医师及时诊断并识别出重症倾向,及时推荐到(重症)收治定点医院进行科学规范救治。
[Objective] To explore the risk factors of HFMD cases and analyze the characteristics of death cases. [Method] The 131 cases of common and severe cases of hand, foot and mouth disease and 16 death cases in eastern part of Henan Province in 2009 were investigated by questionnaire, the information was collected and the database was established. Univariate and multivariate logistic regression analysis was conducted by SPSS15.0 software. To explore the possible risk factors for severe cases. The statistical data of 16 death cases were described. [Results] The three factors of rash site (OR = 1.422), morbidity before and after childbirth (OR = 1.455) and the number of visiting medical institutions (OR = 2.606) in univariate analysis were the most likely risk factors. The factor analysis showed that there was only one variable in the number of medical institutions (P = 0.007), OR = 2.567. The first diagnosis of deaths at the village clinics mostly clinics, diagnosis is not timely, medical treatment more, treatment after admission, positive but ineffective. [Conclusion] The number of visiting medical institutions was a serious risk factor. The number of rash sites and the number of children playing with their children before and after treatment was an important risk factor. The key to reduce the death of hand, foot and mouth disease is the first physician diagnosed in time to identify and identify the severe tendency, promptly recommended to (designated) severe hospitalized for scientific and standardized treatment.