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目的:通过对手足口病死亡病例分析,为重症病例早发现、早诊治减少死亡提供依据。方法:用描述性流行病学方法分析12例死亡病例。结果:死亡病例均为散居儿童,外来儿童为主。死亡病例分布散在,多居住在农村或城郊结合部,居住条件和周围环境差。死亡病例出现的高峰时间在5月底6月初。所有病例均持续高热,91.6%病例以发热起病,66.7%死亡病例在病程41.8小时出现不典型皮疹,66.7%病例早期误诊。死亡病例病程平均80小时,就诊时间14.7小时;83.3%病例出现呕吐,出现时间在病程48.8小时,91.6%病例的病原体为EV 71,60%儿童有接触史。结论:加强疫情监测和病原体检测分析,及早预警,加强医疗机构培训,提高医务人员敏感性;加强健康教育,提高社区居民防制知识,有利于手足口病防控,减少死亡。
OBJECTIVE: To provide a basis for the early detection of severe cases and early diagnosis and treatment to reduce death through the analysis of death cases of hand-foot-mouth disease. Methods: Descriptive epidemiological methods were used to analyze 12 deaths. Results: The deaths were all diaspora and foreign children. Distribution of death cases scattered, and more live in rural areas or suburbs with poor living conditions and the surrounding environment. The peak time of deaths occurred in late May and early June. All cases were sustained fever, fever onset 91.6% of cases, 66.7% of deaths in the course of 41.8 hours of atypical rash, early misdiagnosis of 66.7% of cases. The average duration of death was 80 hours and the treatment time was 14.7 hours. Vomiting occurred in 83.3% of the patients with a duration of 48.8 hours. The pathogens of 91.6% of cases were EV71 and 60% of children had contact history. Conclusion: To strengthen the monitoring of epidemic situation and detection of pathogens, early warning, strengthen the training of medical institutions and enhance the sensitivity of medical staff; strengthen health education and improve community residents’ knowledge of prevention and control, which is beneficial to the prevention and control of hand-foot-mouth disease and reduce the death.