摘要
目的探讨轻症和重症手足口病临床表现、就诊过程及重症发生可能因素。方法按手足口病发病率高低将所辖县分为高中低三层,每层随机抽取一县,每县完全随机抽取病例50例,开展病案、入户和电话调查。结果 14.19%的病例接触手足口病病人后发病,潜伏期3d;与轻症比较,重症病人发热较早,体温高、发热持续时间长;出疹较晚,多部位皮疹;其他症状和体征多在发病后第3天出现,多见精神差、食欲不振、呕吐,心率改变、脑膜刺激征;常并发病毒性脑炎和心肌炎;重症病例首诊确诊率低,转诊多,所需确诊时间长;基层医院手足口病确诊率低。结论重症起病不典型,发病后3d是疾病病程改变的关键期,加强此期对病人的密切观察,及时发现病情的改变、提高基层医院对手足口病的诊断能力,是提高疾病正确分型和及时治疗、控制传染源、减少病死率的关键。
Objective To explore the clinical presentation,medical process of mild and severe hand-foot-mouth disease,as well as the influential factors of severe case.Methods The counties were divided into three layers based on the incidence of hand-foot-mouth disease,one county was randomly selected on each layer and 50 cases were randomly selected in each county by home and the telephone survey.Results 14.19% cases occurred after exposure to the patients and the incubation period was 3 days.Compared with the mild cases,the severe cases were younger with earlier fever,higher body temperature,longer fever.Other symptoms and signs appeared on the third day after disease onset,such as drooping spirits,loss of appetite,vomiting,heart rate changes,meningeal irritation with viral encephalitis and myocarditis.The definite diagnosis rate for first-visit severe cases was low with more referral and long time confirmation,which was more apparent in primary hospital.Conclusions To strengthen the observation of patients on the third day after disease onset,detect changes of the patient and improve the diagnostic ability of primary hospital is crucial for improving the correct classification and timely treatment,controlling source of infection and reducing mortality.
出处
《中华疾病控制杂志》
CAS
2010年第11期1081-1084,共4页
Chinese Journal of Disease Control & Prevention
关键词
手足口病
症状和体征
影响因素
Hand
foot and mouth disease
Symptoms and signs
Influencing factors
