摘要
目的探讨急性危重症患儿死亡的危险因素及临床对策。方法对2002年1月～2005年6月儿童监护病房(PICU)收治的282例患儿在入院第1、3、7天作小儿危重病例评分(PCIS)和全身炎症综合征(SIRS)、多器官功能障碍(MODS)指标的检查,并记录患儿的临床资料。结果SIRS组病死率明显高于非SIRS组(P<0.05);死亡组SIRS病例明显多于存活组,且其PCIS明显降低;PCIS70分以下者病死率高于71～90分者(P<0.01),PCIS越低,病情越重,SIRS病例越多。PCIS与SIRS呈负相关。发生3个或3个以上器官功能障碍时病死率明显高于2个(!2=20.2,P<0.01),随着功能障碍器官数目的增加,死亡率亦增加。结论降低急危重症患儿的病死率关键是积极控制炎症反应,加强护理及临床监护,阻止SIRS向MODS的发展,保护重要器官的功能。
Objective To study the risk factors and countermeasures of children with acute critical illness Methods Prospective analysis of 282 inpatients whose pediatric critical illness score （PCIS）, Systemic inflammatory response syndrome （SIRS） and multiple organs dysfunction syndrome （MODS） were recorded on 1 d,3 d, and 7 d after admission to the Pediatric intensive care unit （PICU） from Jan 2003 to June 2005. Results The fatality rate of the children with SIRS was significantly higher than that of the children with non-SIRS. The PICS of the dead case with SIRS was significanfly lower than that of survival case with SIRS. The fatality rate of the cases with PCIS less than 70 was significantly higher than that of the case with PICS of 71-90 （P〈0.01）. In SIRS cases the PCIS scores were lower and the mortality rate was higher. The fatality rate of the children with 3 or more than 3 organs of dysfunction was signiflcanfly higher than that of the children with 2 organs of dysfunction （X^2=20.2, P〈0.01 ）. The more the dysfunctional organs, the higher was the fatality rate. Conclusion Preventing the development of SIRS to MODS and protecting the function of important organs may play a role in reducing the fatality rate of children with acute critical illness.
出处
《热带医学杂志》
CAS
2006年第5期556-558,共3页
Journal of Tropical Medicine
关键词
儿科危重症
全身炎症反应
多器官功能障碍综合征
pediatric critical illness
systemic inflammatory response syndrome
multiple organ dysfunction syndrome
