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目的掌握乙型脑炎(乙脑)、流行性脑膜炎(流脑)以及其他脑炎、脑膜炎相关疾病的发病情况,为制定免疫策略和防控措施提供依据。方法确定6家监测哨点医院和13家非监测哨点医院,对其报告的脑炎和脑膜炎等相关病例开展流行病学调查和实验室检测,并对调查和实验检测结果进行分析。结果 2006-2009年监测哨点医院报告990例脑炎与脑膜炎相关病例,主要分布在夏秋季,15岁以下儿童占58.36%;其中临床诊断病毒性脑炎和脑膜炎所占比例最大,为39.30%、其次是其他诊断为36.67%。实验室确诊28例乙脑病例,9例流脑病例,流脑病例以C群为主(1例A群,2例B群,6例C群)。并经实验室诊断4例肺炎球菌和1例Hib引起的脑膜炎。临床入院诊断误诊率较高,乙脑临床正确诊断率仅32.14%,流脑仅33.33%。结论应加强乙脑疫苗和流脑疫苗的预防接种,推广使用A+C流脑疫苗。逐步开展肺炎疫苗和Hib疫苗接种。临床应提高实验室诊断脑炎和脑膜炎的能力,减少临床误诊,提高诊疗水平。
Objective To understand the incidence of Japanese encephalitis (JE), meningitis (meningitis) and other encephalitis and meningitis-related diseases and provide the basis for the development of immunization strategies and prevention and control measures. Methods Six monitoring sentinel hospitals and 13 non-monitoring sentinel hospitals were identified. Epidemiological investigations and laboratory tests were conducted on the reported cases of encephalitis and meningitis, and the results of investigation and laboratory tests were analyzed. Results There were 990 cases of encephalitis and meningitis reported in the surveillance sentinel hospitals in 2006-2009, mainly in summer and autumn, accounting for 58.36% of children under 15 years of age. Among them, the largest proportion of clinical diagnosis of viral encephalitis and meningitis was 39.30%, followed by 36.67% for other diagnoses. Laboratory confirmed 28 cases of Japanese encephalitis, 9 cases of meningitis cases, meningitis cases are mainly C (1 A group, 2 cases of B group, 6 cases of C group). And laboratory diagnosis of 4 cases of pneumococcal and 1 case of Hib meningitis. The higher the rate of misdiagnosis of clinical admission diagnosis, the correct diagnosis rate of JE was only 32.14% and that of meningitis was only 33.33%. Conclusions Vaccination of Japanese Encephalitis B vaccine and meningococcal vaccine should be strengthened to promote the use of A + C meningitis vaccine. Gradually carry out pneumonia vaccine and Hib vaccination. Clinical laboratory should improve the ability to diagnose encephalitis and meningitis, reduce clinical misdiagnosis and improve the level of diagnosis and treatment.