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目的分析2012年南宁市兴宁区手足口病重症病例的流行规律及就诊特点,为制定有效的防控策略提供参考依据。方法收集2012年兴宁区手足口病重症病例资料,采用描述性流行病学方法进行分析。结果 2012年南宁市兴宁区共报告手足口病重症3 698例,其中重症病例236例,占总病例的6.38%。乡镇的重症发生率较高,为12.01%,重症病例主要集中在4-7月,5月为高峰期,90.68%的重症病例为4岁以下的儿童,散居儿童占75.42%,男女性别比1.65︰1。重症病例中以EV71阳性为主,占89.16%。重症患儿72 h内的就诊率高达85.55%,转诊次数≥2次占61.44%,初次就诊未作出手足口病诊断占30.93%,首次就诊在县级及以下的医疗机构单位占59.32%。结论2012年南宁市兴宁区重症手足口病的乡镇发生率较高,夏季高发,3岁以下的儿童缺乏保护抗体,散居儿童为主要的发病人群,男性高于女性,主要由EV71引起,并存在诊治不及时等问题,因此做好高发季节重点人群的防控是关键,提高基层医疗机构单位的诊疗水平是重点环节,实现及时就诊,就近诊疗,从而减少重症病例的发生率和病死率。
Objective To analyze the epidemiology and characteristics of HFMD cases in Xingning District in 2012 and provide reference for formulating effective prevention and control strategies. Methods The data of HFMD cases in Xingning District in 2012 were collected and analyzed by descriptive epidemiological method. Results In 2012, a total of 3 698 HFMD cases were reported in Xingning District of Nanning City, 236 of which were severe cases, accounting for 6.38% of the total cases. The incidence of severe diseases in towns and townships was higher at 12.01%. The major cases were concentrated in April-July, the peak was in May, the severe cases were 90.68%, the children under 4 years old, the scattered children accounted for 75.42%, the male-female ratio was 1.65 ︰1. In severe cases, the majority of EV71 positive, accounting for 89.16%. The rate of visiting 85.55% within 72 h of critically ill patients, 61.44% of referral times ≥ 2 times, 30.93% of the patients without initial hand-foot-and-mouth disease diagnosis and 59.32% of first-time visiting medical institutions at county level or below. Conclusion In 2012, the incidence of severe HFMD in Xingning District of Nanning was high. In summer, children under 3 years of age lacked protective antibodies and scattered children were the main incidence groups. The male was higher than that of female and mainly caused by EV71 Therefore, it is the key to prevent and control key population in high season. It is the key point to improve the level of diagnosis and treatment in primary health care units, to achieve timely medical treatment and medical consultation, so as to reduce the incidence and mortality of severe cases.