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目的探讨重症手足口病(HFMD)患儿的临床特征及其危险因素,为防治HFMD提供依据。方法回顾性收集56例重症HFMD病例、56例普通HFMD病例、60例非HFMD儿科病例,比较分析重症组和普通组的临床特征,了解影响重症HFMD发病的危险因素。结果重症HFMD病例组与普通病例组相比,具有发热持续时间长(2.58 d)、热峰高(39.35℃)、外周血WBC计数高(12.49×109/L)、外周血中性粒细胞比例高(57.6%)、血糖浓度高(6.88 mmol/L),ECG(窦速,78.6%)、神经系统(89.3%)、呼吸系统(21.4%)、循环系统(53.6%)、X线异常比例(58.6%)高等特点(P<0.05);影响重症HFMD发病的危险因素包括儿童卫生习惯不良(OR=1.602)、家庭人口密集(OR=2.872)、病例接触史(OR=2.303)、发热持续时间(OR=1.629)、神经系统症状(OR=3.869)、EV71阳性(OR=6.085)、血糖(OR=1.536)。结论了解重症HFMD的临床特征和危险因素,可为早发现、早诊断、早治疗重症HFMD提供临床依据。
Objective To investigate the clinical features and risk factors of severe hand-foot-mouth disease (HFMD) in children and provide evidence for the prevention and treatment of HFMD. Methods Retrospectively collected 56 cases of severe HFMD cases, 56 cases of common HFMD cases and 60 cases of non-HFMD pediatric cases. The clinical features of severe and common HFMD patients were compared and the risk factors influencing the incidence of severe HFMD were analyzed. Results Severe HFMD cases had longer duration of fever (2.58 days), higher peak fever (39.35 ℃), higher peripheral blood WBC count (12.49 × 109 / L), and peripheral blood neutrophil ratio (57.6%), high blood glucose (6.88 mmol / L), ECG (sinus speed 78.6%), nervous system 89.3%, respiratory system 21.4%, circulatory system 53.6% (OR = 2.72), family history of hypertension (OR = 2.872), history of case exposure (OR = 2.303) and fever (OR = 1.629), neurological symptoms (OR = 3.869), EV71 positive (OR = 6.085) and blood glucose (OR = 1.536). Conclusion Understanding the clinical features and risk factors of severe HFMD may provide a clinical basis for early detection, early diagnosis and early treatment of severe HFMD.