2012年和2016年北京儿童医院儿科急诊死亡病例临床特点分析

目的 分析2012年和2016年急诊抢救无效死亡的儿童病例的临床特点.方法 回顾性分析北京儿童医院急诊科2012年和2016年收治并经抢救无效死亡的241例患儿的临床资料及病例特点,比较患儿的性别、年龄、死亡原因.结果 2012年和2016年死亡的患儿分别为122例和119例.2012年死亡病例中,男71例(58.2％),女51例(41.8％);其中0～28 d的新生儿20例(16.4％),29 d至1岁70例(57.4％),＞1～3岁13例(10.7％),＞3～6岁10例(8.2％),＞6岁9例(7.4％);死亡原因以先天性疾病(53/122,43.4％)最多,感染性疾病(38/122,31.1％)次之,意外伤害(17/122,13.9％)居第3,血液病和肿瘤(14/122,11.5％)居第4.2016年死亡病例中,男70例(58.8％),女49例(41.2％);其中0～28 d的新生儿24例(20.2％),29 d至1岁60例(50.4％),＞1～3岁20例(16.8％),＞3～6岁8例(6.7％),＞6岁7例(5.9％);死亡原因以先天性疾病(55/119,46.2％)最多,血液病和肿瘤(47/119,39.5％)次之,感染性疾病(11/119,9.2％)和意外伤害(6/119,5.0％)居第3和第4.2012年因血液病和肿瘤死亡的总人数为14例,其中,0～1岁、＞1～3岁、＞3～6岁、＞6岁分别为1例(7.1％)、2例(14.3％)、4例(28.6％)、7例(50.0％);2016年因血液病和肿瘤死亡的总人数为47例,其中0～1岁、＞1～3岁、＞3～6岁、＞6岁分别为29例(61.7％)、10例(21.3％)、4例(8.5％)、4例(8.5％).与2012年比较,2016年感染性疾病和意外伤害显著减少,血液病和肿瘤显著升高,差异均有统计学意义(P＜0.05).结论 与2012年相比,2016年感染性疾病及意外伤害所致死亡比例明显下降;血液病和肿瘤占比显著升高,且年龄有降低趋势.

Clinical analysis of pediatric emergency death cases in 2012 and 2016 in Beijing Children's Hospital

Objective To analyze and compare the clinical features of death cases in Beijing Children's Hospital emergency department in 2012 and 2016.Methods The clinical data of 241 children who died despite of aggressive rescue treatment in Beijing Children's Hospital emergency department in 2012 and 2016 were analyzed retrospectively.The patient's gender,age and causes of death were compared.Results There were 122 and 119 patients who died despite of aggressive rescue treatment in 2012 and 2016 respectively.In 2012,there were 71 males(58.2％) and 51 females(41.8％) patients died in the emergency room.Among them,20(16.4％) were in 0-28 d,70(57.4％) were in 29 d to 1 year old,13 (10.7％) were in ＞ 1-3 years old,10(8.2％) were in ＞ 3-6years old and 9(7.4％) were older than 6 years old.The most common causes of death were congenital disease (53/122,43.4％) and infectious disease (38/122,31.1％),followed by unintentional injuries (17/122,13.9％),and the fourth was hematological disease and neoplastic disease (14/122,11.5％).In 2016,there were 70(58.8％) males and 49(41.2％) females died.Twenty cases(20.2％) were in 0-28 d,60(50.4％) in 29 d to 1 year old,20(16.8％) in ＞ 1-3 years old,8(6.7％) in ＞ 3-6 years old and 7(5.9％) in ＞ 6 years old.The most common causes of death was congenital disease (55/119,46.2％),the second cause was hematological disease and neoplastic disease (47/119,39.5％),and the next two were infectious disease(11/119,9.2％) and unintentional injuries (6/119,5.0％).The total number of patients who died of hematological disease and neoplastic disease was 14 in 2012,and there were 7.1％,14.3％,28.6％,50.0％ in 0-1,＞ 1-3,＞ 3-6,＞ 6 years old respectively.The total number who died of hematological disease-and neoplastic disease was 47 in 2016,and there were 61.7％,21.3％,8.5％,8.5％ in 0-1,＞ 1-3,＞ 3-6,＞ 6 years old respectively.The number of patients who died of infectious diseases and accidental injuries decreased significantly (P ＜ 0.05) and the number who died of hematological disease and neoplastic disease increased significantly (P ＜ 0.05)in 2016 compared to 2012.Conclusion The proportion of patients who died of infectious disease and accidental injuries decreases significantly and patients died of hematological disease and neoplastic disease increases significantly and tends to be younger.