目的 了解2005年上海儿童流行性腮腺炎(流腮)的流行情况、临床特征和直接经济负担。方法 回顾性横断面临床分析我院传染科确诊的流行性腮腺炎(流腮)890例门诊儿童和270例住院儿童临床资料。结果 流腮在上海地区全年均有发病,4~7月为发病高峰季节,占全年的54.2%。270例住院患儿中,以外来儿童居多,占67.8%,有8例(3.0%)曾经接种过1剂麻疹-风疹-腮腺炎(MMR)疫苗。96.6%的门诊患儿和99.6%的住院患儿为3岁以上儿童。在890例流腮儿童中有并发症患儿234例,占26.3%,其中并发脑膜炎和(或)脑炎205例(87.6%),并发睾丸炎14例(6.0%),并发胰腺炎11例(4.7%),并发耳聋1例(0.4%),有2种或2种以上并发症18例(7.7%)。无死亡病例发生,但有耳听神经损伤后遗症。每一患儿病程中就诊1~3次,平均为1.4次。门诊1次就诊的医疗费用为114.9~184.7元,平均为(142.9±20.5)元,住院患儿总医疗费用624.6~6190.2元,平均为(1897.8±744.2)元。结论 流腮仍是上海儿童中常见的急性呼吸道传染病,并发症较高,幼托机构幼儿和学龄儿童是易感人群,应加强和推广易感人群的疫苗接种,疫苗接种经济有效,可大大降低疾病治疗负担。

Objective To understand the current epidemiological status, clinical futures and economic burden of mumps infection in children in the Shanghai area.Methods A retrospective cross-sectional clinical study was conducted to analyze clinical data from children with mumps including 890 outpatient and 270 inpatient cases occurring in 2005.Results Mumps infections were prevalent throughout the whole year in Shanghai with infections peaking from April through July. Among the 270 inpatient cases, the majority (67.8%) of cases occurred in children of families who were originally living outside Shanghai. Only eight (3.0%) inpatients had received one dose of MMR vaccine. The majority of children with mumps in this inpatient population were older than 3 years. Among the 890 outpatient cases, 234 (26.3%) experienced complications and were admitted to the isolation wards. Complications included meningitis and/or encephalitis (87.6%), orchitis(6.0%),pancreatitis(4.7%),and deafness (0.4%). All patients survived. The direct medical costs for each outpatient clinic visit were between 114.9 and 184.7 Yuan averaging 142.9±20.5 Yuan. The average number of visits was 1.4 per patient. In contrast, the direct medical costs for inpatient admission ranged from 624.6 Yuan to 6190.2 Yuan with costs averaging 1 897.8±744.2 Yuan. Conclusion Mumps is a common communicable disease for children in Shanghai that imposes a threat on children's health. Children attending school are a high-risk, susceptible population. Results from this study show that the mumps vaccine should be routinely administered to children in order to protect them against mumps infection and decrease the complications and financial burdens of this disease.