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目的探讨EV71和CA16感染的手足口病患儿临床特征和危险因素,制定相应的干预对策。方法选取2016年1-12月在本院就诊的EV71、CA16感染所致手足口病患儿80例,其中43例经对症治疗后回归社区。根据再次住院情况分为复诊住院组14例,对照组66例。观察并记录患儿临床症状指标,Logistic回归分析复诊住院的危险因素,针对性提出干预对策。结果患儿平均就诊时间(2.26±0.69)d,血白细胞计数平均(8.86±3.73)×109,平均体温(37.59±1.27)℃,检出EV71感染71例、CA16感染19例。复诊住院组与对照组患儿感染病毒类型、接触史之间差异无统计学意义(P>0.05);就诊时间、就诊体温、白细胞计数、并发症情况两组间差异有统计学意义(P<0.05)。Logistic多因素回归分析显示,就诊时间≥3 d、就诊体温>38.5℃、白细胞计数>10×109、存在并发症均为EV71、CA16感染所致手足口病患儿复诊住院的独立危险因素。结论应增强对存在独立危险因素的患儿回归社区后的日常监察与照护,当症状未明显好转或存在并发症时立即到医院就诊,防治病情向重症发展。
Objective To investigate the clinical characteristics and risk factors of children with hand-foot-mouth disease with EV71 and CA16 infection and to develop corresponding intervention measures. Methods Eighty children with HFMD caused by EV71 and CA16 in our hospital from January to December in 2016 were selected, 43 of whom were returned to the community after symptomatic treatment. According to the rehospitalization, there were 14 cases in the inpatient group and 66 cases in the control group. Observe and record the clinical symptoms of children, Logistic regression analysis of risk factors for hospitalization, targeted interventions. Results The average duration of treatment (2.26 ± 0.69) d, mean white blood cell count (8.86 ± 3.73) × 109, average body temperature (37.59 ± 1.27) ℃, 71 EV71 infections and 19 CA16 infections were detected. There was no significant difference in the type of virus and contact history between the two groups (P> 0.05). There was a significant difference between the two groups in the time of visiting, the temperature of the patients, the number of white blood cells and the complications (P < 0.05). Logistic multivariate regression analysis showed that the treatment time was ≥3 days, the temperature of the clinic was> 38.5 ℃ and the white blood cell count was> 10 × 109. All the complications were the independent risk factors for hospitalization of HFMD children with EV71 and CA16 infection. Conclusions Children with independent risk factors should be strengthened to routinely monitor and take care of their children after they return to the community. When the symptoms have not obviously improved or there are complications, they should go to the hospital immediately to prevent and treat the serious development.