儿童重症监护治疗病房118例重症意外伤害儿童临床及预后分析

目的分析儿童重症监护治疗病房（PICU）重症意外伤害儿童临床及预后情况。 方法回顾性分析广东省佛山市妇幼保健院PICU 2012年1月至2018年10月收治的118例重症意外伤害儿童的一般情况、临床资料和预后情况。对118例患儿的性别、地域分布、来源、有无监护人员在场等资料的组间比较,对不同年龄组儿童重症意外伤害的发生率和种类的比较采用χ²检验。 结果共收治重症意外伤害患儿118例,占同期PICU收治患儿总数的9.60%。在患儿一般情况方面：性别比较差异有统计学意义（男孩72例vs女孩46例,χ²=11.46,P<0.05）;发生意外时有无监护人在场,二者比较差异有统计学意义（有人在场48例vs无人在场70例,χ²=8.20,P<0.05）。患儿的地域分布和来源差异无统计学意义（P均>0.05）。不同年龄组意外伤害的发生例数和发生率：婴儿组39例（33.05%）,幼儿组53例（44.92%）,学龄前儿童组19例（16.10%）,学龄期儿童组6例（5.08%）,青春期组1例（0.85%）。不同年龄组儿童重症意外伤害的发生率差异有统计学意义（χ²=104.72,P<0.05）,幼儿组的发生例数最多。意外伤害种类分别为气管异物41例（34.75%）、窒息22例（18.64%）、中毒18例（15.25%）、溺水14例（11.86%）、交通意外7例（5.93%）、消化道异物7例（5.93%）、烧烫伤3例（2.54%）以及其他6例（5.08%）。不同年龄组意外伤害种类比较,差异有统计学意义（χ²=102.92,P<0.05）。患儿平均住院时间9.48 d,平均住院花费9126元。死亡病例17例,死亡原因中溺水7例,窒息6例,中毒3例,其他1例。 结论重症意外伤害患儿中男孩多见,幼儿组发病例数最多。溺水、窒息是前两位的意外伤害死亡原因。应强化安全意识,注重安全教育,减少儿童意外伤害发生。

Analyze the characteristics and prognosis in one hundred and eighteen children with severe accidental injuries admitted to pediatric intensive care unit

ObjectiveTo analyze the clinical characteristics and prognosis of children with severe accidental injuries admitted to pediatric intensive care unit (PICU). MethodsA retrospective study was performed of general situation, clinical characteristics, and prognosis of 118 children with severe accidental injuries admitted to PICU in Guangdong Foshan Maternal and Children Care Service Centre from January 2012 to October 2018. Gender, geographical distribution, source, and presence or absence of guardian in 118 children were analyzed, and the incidence rate and types of severe accidental injuries in different age groups were compared by the χ² test. ResultsA total of 118 patients were included, accounting for 9.60% of the total number of children admitted to the PICU. In general situation, the differences of gender (72 boys vs 46 girls, χ²=11.46, P<0.05 )and presence or absence of guardian (48 vs 70, χ²=8.20, P<0.05 ) were statistically significant. No significant differences were found in geographical distribution and source (all P>0.05). The number and incidence rate of accidental injuries in different age groups were: 39 cases in infant group (33.05%), 55 cases in toddler group (44.92 %), 19 cases in preschool age group (16.10%), 6 cases in school age group (5.08%), 1 case in adolescent group (0.85%). The incidence rate of severe accidental injuries among different age groups was statistically significant (χ²=104.72, P<0.05), the case of severe accidental injuries in toddler group is the most. The types of severe accidental injuries included 41 cases of foreign bodies in the bronchus (34.75%), 22 cases of suffocation (18.64%), 18 cases of poisoning (15. 25%), 14 cases of drowning (11.86%), 7 cases of traffic accident injury (5.93%), 7 cases of foreign bodies in the gastrointestinal tract (5.93%), 3 cases of burning (2.54%), and 6 cases of others (5.08%). The type of severe accidental injuries among different age groups was statistically significant (χ²=102.92, P<0.05). The average length of hospital stays was 9.48 days, and the average cost was 9,126 RMB. There were 17 deaths, the causes of deaths included drowning (n=7), suffocation (n=6), poisoning (n=3), and others (n=1). ConclusionAmong children with severe accidental injuries, boys are more common, and the incidence is higher in the infant group. Drowning and suffocation are the first two causes of accidental injury related death. In order to reduce accidental injuries, we should strengthen safety education and awareness among parents.