儿童重症手足口病的临床分析及危险因素探究.pdf

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1、垦!垦鱼2014年8月第23卷第8期JETCM．Aug．2014，Vo1．23，No．8—1441一·研究报告·儿童重症手足口病的临床分析及危险因素探究水谭丽琴(广西医科大学第一附属医院西院，广西南宁530007)中图分类号：R512．5文献标志码：A文章编号：1004—745X(2014)08—1441—03doi：10．3969~．issn．1004—745X．2014．08．018【摘要】目的通过临床病例分析，探讨儿童重症手足口病(HFMD)的独立危险因素，为临床早期预警提供依据。方法对225例HFMD患儿按照临床表现分为普通组(170例)和重症组(55例)。采用回顾性分析

2、的方法，收集以上患儿重症诊断指标，进行统计学分析。结果年龄小于3岁、抽搐、意识障碍、精神状态差、神经传导异常、血糖水平大于9mmollL、3d以上体温高于39℃、外周白细胞数大于12X109、颈抵抗，以上9个因素两组间差异有统计学意义(尸<0．01)；对其进行多因素Logistic回归分析显示，年龄小于3岁、精神状态差、3d以上体温高于39℃、神经传导异常、血糖水平大于9mmoUL．为重症儿童HFMD的独立危险因素．具有早期预警作用。结论对于年龄小于3岁，有神经系统症状、精神异常、持续高热的HFMD患儿要高度观察病情的发展，及早制定有效的治疗方案，防止病情恶化。【关键词】儿童HF

3、MD重症危险因素AnalysisofRiskFactorsonChildrenwithHandFootandMouthDiseaseTANLiqin．WestrardoftheFirstAfiliatedFloipitalofGuangriMedicalUniversity，Guangxi，Nanning530007，China【Abstract】Objective：Toinvestigatethecauseofindependentriskfactorsofchildrenwithhandfootandmouthdiseaseexacerbations．andtoprovide

4、thebasisforearlywarningofthisillness．Methods：225Childrenwithhandfootandmouthdiseaseweredividedintocommongroup(170cases)andseveregroup(55cases)accordingtotheclinicalmanifestationsbyretrospectiveanalysismethod．Severediagnosisindexwerecollectedandstatisticalanalysiswascarriedout．Results：9factors

5、includinglessthanthreeyearsofage，convulsions，consciousnessdis-order，poormentalstate，nerveconductionabnormalities，bloodglucoselevelsgreaterthan9mmol／L，threedaysmorethanthetemperatureabove39℃．peripheralwhitebloodcellcountbeinggreaterthan12xlO．andstifneckbetweenthetwogroupshadsignificantstatisti

6、caldifference(P<0．01)；multiplelogisticregressionanalysisshowedthatlessthanthreeyearsofage，poormentalstate，threedaysmorethanthetemperatureabove39℃，nervecon—ducfionabnormalities，bloodglucoselevelsgreaterthan9mmol／Lweretheindependentriskfactorsofhandfootandmouthdiseaseinchildren．whichhadearlywar

7、ningfunction．Conclusion：ChildrenlesstIlanthreeyearsold，withneurologicalsymptoms，mentalabnormalities，andpersistentfeverandmouthdiseaseneedtoofferhighlymonitoringcondition，andtogiveeffectivetherapeuticplanassoonaspossibletopreventdiseasedeterio