摘要
目的探究肠道病毒A71型(EV-A71)病原菌感染手足口病患儿发生重症的相关因素及预防措施。方法选取郑州人民医院2020年10月至2022年2月收治的116例EV-A71感染的手足口病患儿的病历资料进行回顾性分析,根据病情严重程度将其分为轻症组(86例)和重症组(30例),收集并整理所有受试者的临床基础资料,采用logistic多因素回归分析EV-A71感染手足口病患儿发生重症的危险因素。结果重症组居住地城乡接合部、发病至确诊时间>3 d、发热最高温度≥39℃、监护人受教育程度初中及以下占比高于轻症组(P<0.05)。logistic多因素回归分析结果显示,居住地城乡接合部、发病至确诊时间>3 d、发热最高温度≥39℃、监护人受教育程度初中及以下均为EV-A71感染手足口病患儿发生重症的危险因素(P<0.05)。结论重症患儿居住地以城乡接合部为主,发病3 d内确诊是预防病情进展的关键期,发热最高温度≥39℃是重症的早期识别指标之一,监护人受教育程度初中及以下不利于患儿病情防控。对居住地城乡接合部的重点地区及监护人受教育程度偏低的重点人群积极开展健康教育宣传活动,践行早发现、早诊断、早治疗的治疗方案是减少重症病例发生的有效措施。
Objective To explore the related factors and preventive measures of severe hand,foot and mouth disease in children infected with enterovirus A71(EV-A71).Methods The medical records of 116 children with hand,foot and mouth disease infected with EV-A71 in Zhengzhou People's Hospital from October 2020 to February 2022 were retrospectively analyzed.According to the severity of the disease,they were divided into mild disease group(86 cases)and severe disease group(30 cases).The basic clinical data of all subjects were collected and sorted out.The risk factors of severe disease in children with hand,foot and mouth disease infected with EV-A71 were analyzed by logistic regression.Results In the severe group,the proportion of residents living at the junction of urban and rural areas,the time from onset to diagnosis>3 days,the highest temperature of fever≥39℃,and the proportion of guardians with junior middle school education level or below were higher than those in the mild group(P<0.05).The results of logistic multiple regression analysis showed that the risk factors for severe cases of children with hand,foot and mouth disease caused by EV-A71 infection were the urban-rural junction,the time from onset to diagnosis>3 days,the maximum temperature of fever≥39℃,and the educational level of guardians at or below junior high school(P<0.05).Conclusion The place of residence of critically ill children is mainly at the junction of urban and rural areas.The diagnosis within 3 days of onset is the key period to prevent the progress of the disease.The maximum temperature of fever≥39℃is one of the early identification indicators of severe cases.The education level of guardians at or below junior high school is not conducive to the prevention and control of the disease.It is an effective measure to reduce the occurrence of severe cases to actively carry out health education and publicity activities for key areas in the urban-rural fringe of residence and key groups with low educational level of guardians,and to practice the treatment scheme of early detection,early diagnosis and early treatment.
作者
邵青青
张鑫
张琳
SHAO Qingqing;ZHANG Xin;ZHANG Lin(Comprehensive Security Service Center,Zhengzhou People's Hospital,Zhengzhou 450000,China;Emergency Department,Zhengzhou People's Hospital,Zhengzhou 450000,China;Clinical Laboratory Department,Zhengzhou People's Hospital,Zhengzhou 450000,China)
出处
《河南医学研究》
2025年第2期260-263,共4页
Henan Medical Research
