ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2020, Vol. 12 ›› Issue (2): 176-180.doi: 10.3969/j.issn.1674-3865.2020.02.024

• 调查研究 • 上一篇    下一篇

360例儿童急性感染性腹泻临床特点及病原学监测结果分析

张冬雨   

  1. 450018 郑州,郑州儿童医院检验科
  • 出版日期:2020-04-25 发布日期:2021-05-17
  • 作者简介:张冬雨(1989-),女,检验师。研究方向:医学检验,E-mail:ci4can@163.com

Analysis of the clinical features and etiology monitoring results of 360 children with acute infectious diarrhea

  • Online:2020-04-25 Published:2021-05-17

摘要: 目的 分析急性感染性腹泻患儿临床特点及病原学特征,为该病的临床治疗及防控决策提供一定依据。
方法 回顾性抽取2017年1月至2018年12月我院儿科诊治的360例急性感染性腹泻患儿的临床资料(人口学资料、相关生活习惯、病情数据记录等),采集粪便标本进行病原体检测,主要检测易导致儿童腹泻的常见8种细菌与6种病毒,并进行总结分析。
结果 不同性别患儿年龄分布无统计学差异(P>0.05),发病年龄集中于5岁以内(占89.17%);腹泻频次以3~5次/天最多,另可伴发热、恶心、呕吐、腹痛症状。居住环境为农村者占比高于城镇,有饭前洗手、便后洗手、不喝生水、勤剪指甲习惯者占比均低于50%。360份粪便标本中常见病原体总检出率为4917%(177/360),其中病原菌检出率为15.56%(56/360),病毒核酸检出率为33.61%(121/360)。2017年、2018年病原体检出率比较差异无统计学意义(P>0.05),检出的病原菌均以沙门菌、肠致泻性大肠埃希菌为主,病毒均以轮状病毒、诺如病毒为主;2017年、2018年常见细菌、病毒检出率比较差异无统计学意义(P>0.05)。儿童急性细菌性感染腹泻秋、夏季占比明显高于春冬季(P<0.05),但不同季节各病原菌占比差异无统计学意义(P>0.05);急性病毒性感染腹泻秋、冬季占比明显高于春夏季(P<0.05),且冬季轮状病毒明显高于其他季节,秋季诺如病毒明显高于其他季节(P<0.05)。
结论 2017~2018年本院急性感染性腹泻患儿具有低龄、自身或家庭卫生较差、秋冬季多发、以病毒和细菌感染为主的临床特点,病毒以轮状病毒、诺如病毒为主,病原菌以沙门菌、肠致泻性大肠埃希菌为主,相关部门应据此采取相应措施控制儿童急性感染性腹泻的发病率。

关键词: 急性感染性腹泻, 临床特点, 病原体, 儿童

Abstract: Objective To analyze the clinical features and etiology features of children with acute infectious diarrhea, and to provide basis for the clinical treatment and prevention strategy of the disease.
Methods The clinical data (demographic data, related living habits, disease data records, etc.) of 360 children with acute infectious diarrhea who were diagnosed and treated in pediatric department of our hospital from January 2017 to December 2018 were retrospectively collected. Fecal specimens were collected for pathogen detection. The main detection contents included 8 kinds of common bacteria and 6 kinds of viruses causing diarrhea in children. Summary and analysis were performed.
Results There was no significant difference in age distribution among children with different genders(P>0.05). The onset age was concentrated within 5 years(89.17%). The diarrhea frequency of 3 to 5 times/d was the most common, complicated with fever, nausea, vomiting and abdominal pain. The proportion of people living in rural areas was higher than that in urban areas. The proportion of people with habits such as washing hands before meals, washing hands after using bathroom, no drinking of raw water and regular cutting of nails was less than 50%. Among the 360 fecal specimens, the total detection rate for common pathogens was 49.17%(177/360), including detection rate for pathogenic bacteria (15.56%,56/360) and detection rate for viral nucleic acid(33.61%,121/360). There was no significant difference in detection rate for pathogens between 2017 and 2018(P>0.05). The pathogens that were detected out were mainly Salmonella and enterodiarrheal Escherichia coli, and the viruses were mainly rotavirus and norovirus. There was no difference in the detection rate of common bacteria or viruses between 2017 and 2018(P>0.05). The proportion of acute bacterial diarrhea in autumn and summer was significantly higher than that in spring and winter(P<0.05), but the proportion of pathogenic bacteria in different seasons was not statistically different(P>0.05); the proportion of acute viral diarrhea in autumn and winter was significantly higher than that in spring and summer(P<0.05), and the proportion of rotavirus in winter was significantly higher than that in other seasons, and norovirus in autumn was significantly higher than that in other seasons(P<0.05).
Conclusion From 2017 to 2018, the children with acute infectious diarrhea in the hospital are characterized by low age, poor self or family health, frequent onset in autumn and winter, bacterial and viral infections. The viruses are mainly rotavirus and norovirus. The pathogens are mainly Salmonella and entero-diarrheal Escherichia coli. Accordingly, the relevant departments should take corresponding measures to control incidence of acute infectious diarrhea in children.

Key words: Child, Acute infectious diarrhea, Clinical feature, Pathogen