手足口病患儿复诊住院相关因素分析及护理对策  

Relative factors of return visit for hospitalization of children with hand-foot-mouth disease and nursing care

作　　者：徐灿丽[1] 陈虹[1] 张艳华[1] 侯志文[1] 李岩[1] 李春梅[1] 

机构地区：[1]北京地坛医院门诊部,100015

出　　处：《中华护理杂志》2009年第3期246-248,共3页Chinese Journal of Nursing

摘　　要：目的探讨手足口病(HFMD)患儿初诊回归社区再次就诊并收住院(RVH)的相关因素及护理措施。方法以2008年5月北京地坛医院初诊回归社区的180例HFMD患儿中复诊住院的17例为对象(RVH组),其余163例为对照组,Logistic回归分析患儿RVH可能危险因素,评价独立危险因素对RVH的预测价值并总结RVH患儿的护理措施。结果RVH组患儿发病至就诊间隔时间(3.71±1.10)d、初诊体温(38.74±0.57)℃、外周血白细胞计数(10.99±3.67)×109,与对照组比较,均延长或增高,差异具有统计学意义(P<0.05),并伴有高危症状。多因素分析提示就诊时间超过3d、体温超过38.5℃、白细胞计数≥10.0×109和伴随高危症状是RVH的独立危险因素。具有上述3项以上危险因素患儿RVH率达68.75%(11/16),诊断敏感性64.71%、特异性96.93%。结论独立危险因素达到3项的患儿不应回归社区,住院观察有助于改善RVH患儿预后,避免患儿疾病向重症发展。Objective To explore the nursing care and relative factors of return visit for hospitalization of children with hand-foot-mouth disease （HFMD） who had been repatriated to community after preliminary diagnosis. Methods 180 children with HFMD who had been repatriated to community after preliminary diagnosis in Beijing Ditan Hospital were invited to participate in this study on May of 2008. Of them,17 children who requested to return visit for hospitalization one group,and the remaining 163 children another group. Logistic regression was used to analyze the relative factors of return visit for hospitalization,and summarized the nursing care of children with HFMD who required return visit and hospitalization. Results For the return group,temperature was（38.74±0.57）℃, interval between invasion and visit was（3.71±1.10）d,WBC counts was（lO.99±3.67）×10^9. These were significantly higher than the other group （P〈0.05）. Interval between invasion and visit more than 3 days,body temperature at first visit higher than 38.5℃,peripheral WBC counts more than 10.0×10^9,and complicating risk symptoms were confirmed to be the risk factor related to return visit. 68.75% cases（11/16） of children who had return visit had these three and more factors with the diagnosis sensitivity of 64.71% and specificity of 96.93%. Conclusions Children with more than above three risk factors should he closely monitored in hospital and not he repatriated to community after prelirninary diagnosis.

关 键 词：手足口病 病人再入院 危险因素 健康教育 

分 类 号：R473.72[医药卫生—护理学] R512.5[医药卫生—临床医学]