简化小儿危重病例评分法在手足口病中的临床应用价值
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摘要
目的探讨简化小儿危重病例评分法(简化PCIS)在手足口病患儿病情评估及预后判断中的应用价值。方法选择广宁县人民医院儿科2013年3月至2018年10月间诊治的105例手足口病患儿为研究对象,入院后予简化PCIS评分,将22例简化PCIS评分≤64分的患儿纳入观察组,余83例患儿简化PCIS评分>64分者纳入对照组,比较两组患儿的临床疗效指标及死亡率。结果观察组患儿的退热及疱疹消失时间、住院时间分别为(2.24±0.83) d、(6.24±1.62) d、(7.16±2.65) d,明显长于对照组的(4.79±1.52) d、(9.36±2.78) d、(12.95±3.81) d,差异均有统计学意义(P<0.05);观察组患儿的预后良好率为72.73%,明显低于对照组的95.18%,而死亡率为13.64%,明显高于对照组(0),差异均均有统计学意义(P<0.05)。结论简化小儿危重病例评分法可有效判断手足口病患儿的病情严重程度,并在临床治疗效果及疾病预后的预测中具有重要意义
Objective To explore the application value of simplified pediatric critical illness scoring(PCIS) in the evaluation and prognosis of children with hand, foot and mouth disease(HFMD). Methods A total of 105 children with HFMD were selected as subjects, who were diagnosed and treated in the Department of Pediatrics at Guangning People's Hospital from March 2013 to October 2018. After admission, the children were given the simplified PCIS score,of which 22 children with simplified PCIS score ≤64 were included into the observation group, and the remaining 83 children with simplified PCIS score >64 were included into the control group. The clinical efficacy and mortality were compared between the two groups. Results The time of fever abatement, herpes disappearance, and hospitalization in the observation group were(2.24±0.83) d,(6.24±1.62) d, and(7.16±2.65) d, respectively, which were significantly longer than corresponding(4.79±1.52) d,(9.36±2.78) d, and(12.95±3.81) d in the control group(P<0.05). In the observation group, the good rate of prognosis was 72.73%, which was significantly lower than 95.18% in the control group; and the mortality rate was 13.64%, which was significantly higher than 0 in the control group; both differences were statistically significant(P<0.05). Conclusion Simplified PCIS can effectively judge the severity of HFMD in children, and is of great significance in the clinical treatment effect and the prediction of disease prognosis.
Objective To explore the application value of simplified pediatric critical illness scoring(PCIS) in the evaluation and prognosis of children with hand, foot and mouth disease(HFMD). Methods A total of 105 children with HFMD were selected as subjects, who were diagnosed and treated in the Department of Pediatrics at Guangning People's Hospital from March 2013 to October 2018. After admission, the children were given the simplified PCIS score,of which 22 children with simplified PCIS score ≤64 were included into the observation group, and the remaining 83 children with simplified PCIS score >64 were included into the control group. The clinical efficacy and mortality were compared between the two groups. Results The time of fever abatement, herpes disappearance, and hospitalization in the observation group were(2.24±0.83) d,(6.24±1.62) d, and(7.16±2.65) d, respectively, which were significantly longer than corresponding(4.79±1.52) d,(9.36±2.78) d, and(12.95±3.81) d in the control group(P<0.05). In the observation group, the good rate of prognosis was 72.73%, which was significantly lower than 95.18% in the control group; and the mortality rate was 13.64%, which was significantly higher than 0 in the control group; both differences were statistically significant(P<0.05). Conclusion Simplified PCIS can effectively judge the severity of HFMD in children, and is of great significance in the clinical treatment effect and the prediction of disease prognosis.
引文
[1]孙璐露,郭放,高玉霞. 946例小儿手足口病流行病学特征分析[J].中国实用医药, 2013, 8(17):260-261.
[2]沈怀云,诸宏伟,周瑞,等.手足口病患儿血清白蛋白水平与预后的相关性[J].临床儿科杂志, 2014, 32(10):945-947.
[3]张红,黄海忠,林国栋,等.血清降钙素原对手足口病患儿病情变化和预后判断的价值[J].中国中西医结合儿科学, 2014, 6(4):335-336, 337.
[4]李建明,刘映霞,林益敏,等. 258例手足口病中枢神经系统并发症的临床特征及预后分析[J].中华实验和临床病毒学杂志, 2014, 28(4):241-244.
[5]中华人民共和国卫生部.手足口病诊疗指南(2010年版)[J].国际呼吸杂志, 2010, 30(24):1473-1475.
[6]中华医学会儿科学会急救组.小儿危重病例评分法(草案)[J].中华儿科杂志, 1995, 33(6):370-373.
[7]杨永莲,宋蕾.阿昔洛韦治疗小儿手足口病临床疗效观察[J].中国现代药物应用, 2014, 8(19):155-156.
[8]陈世友,黎晓绮,陈坚.手足口病的流行病学特征及临床预防情况分析[J].海南医学, 2015, 26(13):1984-1986.
[9] PAN J, CHEN M, ZHANG X, et al. High risk dactors for severe hand, foot and mouth disease:a multicenter retrospective survey in Anhui province China, 2008-2009[J]. Indian Journal of Dermatology, 2012, 57(4):316-321.
[10]陈丽,彭婉君,骆庆明,等.重症手足口病的相关危险因素分析[J].海南医学, 2014, 25(5):667-669.
[11]徐艳利,田庆玲,姜太一,等.雾化吸入重组人干扰素α1b对重症手足口病早期的治疗作用[J].中华实用儿科临床杂志, 2015, 30(8):627-630.
[12]李幸乐,李懿,张白帆,等.河南省2014年手足口病重症病例病原学分析[J].中华流行病学杂志, 2016, 37(4):568-571.
[13]曲沛,徐新民,赵苗苗,等.重症手足口病患儿合并肺炎支原体感染实验室检测指标对于临床诊断及治疗的提示性作用[J].首都医科大学学报, 2015, 36(4):601-603
[14]李宏波,吴志刚,徐爱芳.重症手足口病患儿外周血炎性细胞因子表达与临床意义[J].中华医院感染学杂志, 2015, 25(19):4371-4374.
[15]谢峰,田艳娟.小儿危重病例评分法在儿童重症监护病房中的应用[J].宁夏医科大学学报, 2013, 35(5):583-584.
[16]许玉芳,王艳丽.血乳酸清除率与PCIS评分对危重症患儿预后评估价值的比较[J].中国基层医药, 2016, 23(2):301-303.
[17]邱慧明,黄昀.小儿危重病例评分在儿科重症监护病房转出决策中的应用[J].中国全科医学, 2012, 15(2):205-206.
[2]沈怀云,诸宏伟,周瑞,等.手足口病患儿血清白蛋白水平与预后的相关性[J].临床儿科杂志, 2014, 32(10):945-947.
[3]张红,黄海忠,林国栋,等.血清降钙素原对手足口病患儿病情变化和预后判断的价值[J].中国中西医结合儿科学, 2014, 6(4):335-336, 337.
[4]李建明,刘映霞,林益敏,等. 258例手足口病中枢神经系统并发症的临床特征及预后分析[J].中华实验和临床病毒学杂志, 2014, 28(4):241-244.
[5]中华人民共和国卫生部.手足口病诊疗指南(2010年版)[J].国际呼吸杂志, 2010, 30(24):1473-1475.
[6]中华医学会儿科学会急救组.小儿危重病例评分法(草案)[J].中华儿科杂志, 1995, 33(6):370-373.
[7]杨永莲,宋蕾.阿昔洛韦治疗小儿手足口病临床疗效观察[J].中国现代药物应用, 2014, 8(19):155-156.
[8]陈世友,黎晓绮,陈坚.手足口病的流行病学特征及临床预防情况分析[J].海南医学, 2015, 26(13):1984-1986.
[9] PAN J, CHEN M, ZHANG X, et al. High risk dactors for severe hand, foot and mouth disease:a multicenter retrospective survey in Anhui province China, 2008-2009[J]. Indian Journal of Dermatology, 2012, 57(4):316-321.
[10]陈丽,彭婉君,骆庆明,等.重症手足口病的相关危险因素分析[J].海南医学, 2014, 25(5):667-669.
[11]徐艳利,田庆玲,姜太一,等.雾化吸入重组人干扰素α1b对重症手足口病早期的治疗作用[J].中华实用儿科临床杂志, 2015, 30(8):627-630.
[12]李幸乐,李懿,张白帆,等.河南省2014年手足口病重症病例病原学分析[J].中华流行病学杂志, 2016, 37(4):568-571.
[13]曲沛,徐新民,赵苗苗,等.重症手足口病患儿合并肺炎支原体感染实验室检测指标对于临床诊断及治疗的提示性作用[J].首都医科大学学报, 2015, 36(4):601-603
[14]李宏波,吴志刚,徐爱芳.重症手足口病患儿外周血炎性细胞因子表达与临床意义[J].中华医院感染学杂志, 2015, 25(19):4371-4374.
[15]谢峰,田艳娟.小儿危重病例评分法在儿童重症监护病房中的应用[J].宁夏医科大学学报, 2013, 35(5):583-584.
[16]许玉芳,王艳丽.血乳酸清除率与PCIS评分对危重症患儿预后评估价值的比较[J].中国基层医药, 2016, 23(2):301-303.
[17]邱慧明,黄昀.小儿危重病例评分在儿科重症监护病房转出决策中的应用[J].中国全科医学, 2012, 15(2):205-206.