海南省2009～2010年手足口病死亡病例流行特征分析  

Analysis on epidemic characteristics of deaths of hand-foot-mouth disease(HFMD)in Hainan,2009-2010

作　　者：黄芳[1] 邱丽[1] 李臻[1] 陈海云[1] 苏新元[1] 潘正帆[1] 金玉明[1] 

机构地区：[1]海南省疾病预防控制中心,海南海口570203

出　　处：《中国热带医学》2011年第10期1204-1205,共2页China Tropical Medicine

基　　金：海南省卫生厅重点科研项目(琼卫2010重点-41)

摘　　要：目的分析海南省2009-2010年手足口病死亡病例流行病学特征,为下一步手足口病重症病例防控工作提供科学依据。方法对死亡病例进行个案调查,收集流行病学、临床表现、诊治过程、实验室检测等资料,进行描述性分析。结果 2009年全省累计报告手足口病11 845例,其中死亡病例11例,病死率0.93‰;2010年全省累计报告手足口病25 142例,其中死亡病例5例,病死率0.19‰。16例死亡病例主要分布在乡镇、农村,均为散居儿童,年龄均在3岁及以下。早期临床表现多为先发热,后出疹,病情进展迅速,最终因呼吸、循环衰竭而死亡,发病至死亡平均间隔3.2天。14例病例首诊单位为县级及以下医疗机构,早期诊出率低(21.43%)。县级医院手足口病危重病例抢救成功率低(0/15)。12例病例经实验室检测,EV71阳性8例(占实验室阳性比例为88.89%)。结论手足口病重症病例防控重点人群仍为3岁以下儿童。县级医院是手足口病重症病例防控工作中的一道重要关卡。应加强对县级医院重症救治的支持,强化危重症早期识别和救治能力的培训,做到早期识别、有效抢救,降低海南省手足口病重症病例死亡率。Objective To analyze the epidemic characteristics of the fatality cases of hand-foot-mouth disease（HFMD）in Hainan,during 2009 to 2010,and provide scientific proof for a further prevention for HFMD severe cases.Method Investigated every death cases,collecting the data about epidemic histories,clinical features,diagnosis,treatments and Etiological detecting results,and analyze the data with descriptive epidemiological methods.Result 11 845 cases of HFMD were reported in 2009,including 11death cases,mortality rate was 0.93‰;25 142 HFMD cases were reported in 2010,including 5 death cases,mortality rate was 0.19‰.16 deaths were mainly distributed in towns and countryside.All the death cases were scattered children who were under 3 years old.The early clinical feature was that rashes came after fever,then disease progressed extremely fast.Patients eventually died of respiratory and circulation failure.The average interval from disease onset to death was 3.2days.The first medical institutions which 14cases came to were hospitals of county and below that level.Rate of early diagnosis of those hospitals was 21.43%.County hospitals are extremely important to the prevention and control for severe cases of HFMD.It is essential to improve the treatment of sever cases in those county hospitals in the areas where sever cases occurs frequently.Correct first～diagnosis and timely effective therapies are the key means to avoid fatality cases of HFMD in Hainan province.

关 键 词：手足口病 死亡病例 流行特征 分析 

分 类 号：R512.5[医药卫生—内科学]