肠道病毒IgM抗体快速检测在手足口病护理管理中的应用  

Rapid detection of enterovirus IgM improve the nursing management of children with hand-foot-mouth disease

作　　者：黄基红[1] 黄乐听[1] 金洁[1] 徐武秀[1] 林海龙[1] HUANG Ji-hong HUANG Le-ting JIN Jie et al(Department of Pediatric Infection, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhefiang 325003, Chin)

机构地区：[1]温州医科大学附属第二医院儿童感染科,浙江温州325003

出　　处：《中华全科医学》2017年第9期1612-1615,共4页Chinese Journal of General Practice

基　　金：浙江省自然科学基金项目(2013RCB011);温州市科技计划项目(Y20130022)

摘　　要：目的探讨肠道病毒Ig M快速检测提升手足口病护理管理质量的作用。方法选择温州医科大学附属第二医院2015年5月份符合手足口病诊断的治疗病例126例纳入本次研究,进行随机对照试验(RCT),分别设立非病原学快速诊断组(Ⅰ组,62例)和病原学快速诊断组(Ⅱ组,64例)。Ⅰ组不进行肠道病毒Ig M抗体检测,仅采集咽拭子及粪便标本送检PCR检测,统一分配病房,并采取手足口病常规护理。Ⅱ组同时进行肠道病毒Ig M抗体(胶体金法)和PCR检测,根据病原学不同分别归入相应隔离病房,并采取不同的护理模式。比较2组患儿病原学的差异,比较Ⅱ组Ig M抗体和PCR检测结果的差异。比较2组患儿住院时间的差异,并调查出院2周内再次感染的情况。结果 2组患儿病原学比较差异无统计学意义(P=0.927),Ⅱ组胶体金法与PCR法检测的对应准确率为98.4%。Ⅱ组患儿住院时间较Ⅰ组患儿时间缩短(P<0.001)。Ⅰ组再次感染例数为8例,而Ⅱ组则没有再次感染病例,差异有统计学意义(P<0.001)。结论胶体金法检测手足口病病毒Ig M的方法,可快速检测病原学,医护人员可据此分别隔离并进行相应的治疗和护理,提高治疗和护理的针对性,提升护理管理质量,缩短住院时间,同时可降低病房内的二次感染。Objective To investigate the role of rapid detection of enterovirus IgM on improving the nursing management of children with hand-foot-mouth disease. Methods Total 126 patients who met the diagnostic criteria for hand-foot- mouth disease in May,2015 were enrolled into this study with randomized controlled trials（RCTs）. All the patients were assigned into non-pathogenic rapid diagnosis group （Group I , 62 cases ） and pathogenic rapid diagnosis group （Group II ,64 cases）. In group I,the stool and throat swabs specimen were prepared for PCR test;the patients were uniformly as- signed into wards and received the routine nursing care. In group II , the tests for IgM antibody （ colloidal gold assay ） were additionally performed, and the patients were assigned into isolation ward according to the different pathogens, and received individualized care. The differences of pathogen, results of PCR and antibody tests, hospitalization time and rate of re-infection within two weeks were compared. Results There was no statistical difference of pathogen between the two groups （P = 0.927 ） , and the corresponding accuracy rate of between PCR and antibody tests was 98.4%. The hospitaliza- tion time of Group II was shorter than that of Group I （P 〈0. 001 ）. There were 8 re-infection cases in Group I ,while 0 cases in I group, the difference was significant differences （P 〈 0. 001 ）. Conclusion The colloidal gold assay method is effective in the detection of hand-foot-mouth disease virus IgM. According to the results of rapid pathogenic tests, the medical personnel can assign patients with different pathogens into isolation wards, and provide individualized care and treatment, thus will improve the pertinence of treatment and care and the quality of nursing management, shorten the hospi- talization time, also reduce secondary infection in the ward.

关 键 词：手足口病 肠道病毒 护理管理 胶体金法 

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