反复感染手足口病患儿的预防和治疗

目的探讨消毒隔离结合免疫及营养治疗在预防和治疗反复感染手足口病患儿中的作用。方法收集初次就诊的手足口病患儿共400例,利用随机数字表将患者分为治疗组与对照组各200例,治疗组患儿定期给予消毒隔离健康教育及营养随访,再次患病后给予个体化营养支持治疗。对照组患儿仅在感染手足口病后给予常规治疗。比较两组患儿手足口病再发率和重症率等指标。结果治疗组患儿平均退热时间为(1.7±1.1)d、皮疹消退时间为(4.0±1.3)d、平均住院天数为(5.6±2.4)d、抗菌药物使用率为19%(38/200)、激素使用率为8%(16/200),均显著低于对照组,差异具有统计学意义(t=10.028、8.677、8.353、20.650、11.312,P=0.015、0.032、0.001、0.004、0.011)。治疗组患儿1年内再发率、重症率和并发症发生率分别为12%(24/200)、1%(2/200)和5%(10/200),显著低于对照组患儿,差异均有统计学意义(χ~2=9.21、0.88、7.24,P=0.010、0.002、0.007)。结论健康教育、营养随访及个体化营养支持治疗可降低手足口病的再发率及重症率,改善临床结局。

Prevention and treatment of recurrent infections in children with hand,foot and mouth disease

ObjectiveTo investigate the effect of sterilization and isolation combined with immune and nutritional therapy in preventing and treating repeated infection of hand, foot and mouth disease (HFMD). MethodsTotal of 400 children with HFMD were randomly divided into treatment group (200 cases) and control group (200 cases). Individual nutritional support was given after re-illness. Children in the control group were only given conventional treatment after HFMD. The recurrence rate and severity rate were compared between the two groups, respectively. ResultsFor the treatment group, the mean antipyretic period was (1.7 ± 1.1) days, the rash subsiding period was (4.0 ± 1.3) days, the average hospitalization period was (5.6 ± 2.4) days, and the application rates of antibiotics and hormone were 19% (38/200) and 8% (16/200), which was significantly lower than those of the control group (t = 10.028, 8.677, 8.353, 20.650, 11.312; P = 0.015, 0.032, 0.001, 0.004, 0.011). Recurrence rate within one year of cases in treatment group, the incidence of severe disease and complications were 12% (24/200), 1% (2/200) and 5% (10/200), respectively, all significantly lower than those of the control group, with significant differences (χ² = 9.21, 0.88, 7.24; P = 0.010, 0.002, 0.007). ConclusionsThe combination of health education, nutritional follow-up and individualized nutrition support therapy can reduce the recurrence rate and severe rate of HFMD and improve the clinical outcome.