目的 为手足口病的防治提供临床参考资料.方法 对本院2011年1-9月收治的手足口病患者做一回顾性分析.结果 456例中,男女比例为2.10∶1；发病年龄主要集中在1～5岁,5岁以下408例,占89.47％;发病时间4-6月份298例,占65.35％;地区分布以农村占多,有340例,占74.6％；临床特征包括疱疹,主要分布在:手足452例(99.12％),口腔粘膜406例( 89.03％)；252例伴发热(55.26％),合并肺炎有54例(11.84％),出现神经系统症状56例(7.5％),并发心肌损害的24例(5.26％)；其中发现一些特殊表现:无症状性肺炎26例(5.70％),不明显原因的指(趾)甲损害7例(1.53％).重症患儿12例(2.63％),危重病例2例(0.04％).127份标本病原学检测EV71阳性70例(55.11％),CVA16阳性43例(33.86％).本组患者按照2010年手足口病防治指南治疗,患儿预后良好,有神经系统后遗症1例,死亡病例1例.结论 本次流行高峰期为4-6月份,好发于1～5岁儿童,本次流行以EV71为主要病原体.手足口病的防治关键是掌握危重症的危险因素,严格按照2010年手足口病防治指南治疗,并在疾病早期做到早诊断,早治疗,可有效减少后遗症、降低病死率.%Objective To provide clinical reference materials for hand,foot and mouth disease ( HFMD ).Methods The data on the patients with HFMD who had been hospitalized from January 2011 to September 2011 were retrospectively analyzed.Results Of 456 patients,309 were female and 147 were male,with a ratio of 2.10∶1.408 ( 89.47％ )children aged under 5; 208 ( 45.6％ )had an onset in April to June; 340 ( 74.6％ ) came from the rural areas.The clinical features included herpes,mainly distribuing on hand and food in 452 children ( 99.12％ ) and on oral mucosa in 406( 89.03％ ).252( 55.26％ ) children had fever; 54( 11.84％ ) developed pneumonia; 56( 7.5％ ) occurred nervous system symptoms; 24 ( 5.26％ ) had myocardial injury.Some special appearances were found.Asymptomatic pneumonia occurred in 26 ( 5.70％ ) children; damage to finger nail or toe nail with unknown reasons developed in 7 ( 1.53％ ).12 ( 2.63％ ) children were severe and 2 ( 0.04％ ) were in critical condition.70 of 127 ( 55.11％ ) specimens were positive with EV71 infection and 43 ( 33.86％ )were positive with CVA16 infection.The children received therapies according to the 2010 guidelines for prevention and treatment of hand, foot and mouth disease.The prognosis was fairly good.One child developed nervous system sequela and one was dead.Conclusions This prevalent peaked in April to June,most commonly occurred in children aged 1 to 5,and had the leading pathogen being EV71.The key to prevention and treatment of hand,foot and mouth disease is to identify the risk factors of critical cases,strictly abide by the 2010 guidelines for prevention and treatment of hand,foot and mouth disease,and confirm diagnosis and administer treatment as early as possible in the early stage of the disease,which can effectively reduce sequela and mortality.
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