幼儿急疹发生危险因素分析.docVIP

幼儿急疹发生危险因素分析 　　[摘要] 目的 分析幼儿急疹发生的危险因素，便于临床早期识别。 方法 收集2015年8月～2017年7月无锡市第五人民、无锡市惠山区第三人民医院儿科以急起高热就诊的175例2岁以下、精神状态良好患儿的临床资料进行回顾性分析。对性别、月龄、季节、入院时体温、精神状态、咽部充血、扁桃体渗出灶、中性粒细胞数、淋巴细胞细胞百分比等，可能预测诊断为幼儿急疹的危险因素进行Logistic回归分析。 结果 175例患儿中132例最终确诊为幼儿急疹，发生率为75.4%。单因素分析结果显示发病患儿的精神食欲、扁桃体渗出灶、中性粒细胞数的差异有统计学意义（P 0.05）；多因素Logistic回归结果显示，季节（OR = 3.393，P 0.05）、精神食欲（OR = 0.043，P 0.01）、腭扁桃体渗出灶（OR = 0.179，P 0.01）、中性粒细胞（OR = 0.318，P 0.05）均是幼儿急疹发生的危险因素。 结论 季节、精神食欲、扁桃体渗出灶及中性粒细胞数是2岁以下急起高热小儿发生幼儿急疹的危险因素。合理治疗，及时和家长沟通，可缓解家长的恐慌情绪，有效避免过度检查、过度治疗，避免不合理用药和抗生素的滥用。 　　[关键词] 幼儿急疹；人疱疹病毒6、7型；扁桃体渗出灶；粒细胞减少 　　[中图分类号] R725.11 [文献标识码] A [文章编号] 1673-7210（2018）03（c）-0089-04 　　[Abstract] Objective To analyze the risk factors of occurrence of exanthema subitum， for clinical early recognition. Methods From August 2015 to July 2017， in Departemnt of Paediatrics， the Fifth People′s Hospital of Wuxi and the Third People′s Hospital of Huishan District， the clinical data of 175 less than 2 years old children with high fever， good mental state were collected and retrospectively analyzed， the factors such as gender， age， season， body temperature at admission， mental state， pharyngeal hyperemia， tonsillar exudation， neutrophil count， lymphocyte cell percentage and so on which could predict the exanthema subitum diagnosis were analyze by Logistic regression analysis model. Results In 175 children， 132 cases were diagnosed as exanthema subitum， the composition ratio was 75.4%. The results showed that the differents of mental states appetite， tonsil exudation and neutrophil counts of single factors were statistically significant （P 0.05）， the multivariate Logistic regression analysis showed that the seasons （OR = 3.393， P 0.05）， mental appetite （OR = 0.043， P 0.01）， tonsil exudation （OR = 0.179， P 0.01） and neutrophil count （OR = 0.318， P 0.05） were dangerous factors of 2 years old children with high fever got exanthema subitum. Conclusion The season， mental appetite， tonsil exudation and neutrophil count are dangerous f