小儿死亡危险评分的临床应用

Clinical Application of Pediatric Risk of Mortality Score in Pediatric Intensive Care Unit

目的观察小儿死亡危险评分(PRISM评分)与PICU急性危重症患儿预后的关系。方法对2003年2-10月PICU收治急性危重症45例,回顾性评定PRISM评分,并依据评分分组,记录患儿临床资料和住院时间、预后。结果PRISM 评分<15分24例,>15分21例。两组年龄、体质量和院内感染率均无显著差异(P均>0.05)。两组死亡率分别为8.1%(2/ 24例)和38.1%(8/21例),PRISM评分<15分组死亡率明显低于>15分组(x2=4.14 P<0.05)。PRISM>15分组存活病例住院天数(13.2±6.1)d显著长于PRISM<15分组(9.7±8.5)d(t=1.74.P<0.05)。结论PRISM评分越高,死亡率随之增加。PRISM评分增高,患儿住院时间越长。PRISM评分能够准确评估急性危重症病人的严重程度和预后。

Objective To investigate the significance and correlation of pediatric risk of mortality（PRISM）score and prognosis of acute ,severe patients in pediatric intensive care unit（PICU）. Methods Forty - five sick patients in PICU were studied and the clinical data were recorded. PRISM ,score was calculated retrospectively. Forty - five patients were divided into 2 groups according to the PRISM score, meanwhile recording the clinical date, duration of hospitalization and prognosis. Results Twenty - four children＇ s PRISM score 〈 15 scores, PRISM score of the other 21 causes 〉 15 ,scores. The expected death of the group was 8.1% （ n = 2）. Among 21 children with the .score 〉 15, the mortality was 38.1% （ n = 8）. There was significantly difference both in mortality（ X^2 = 4, 14 P 〈0.05）and the duration of hospitalization of the patients cured （ t = 1.74 P〈0.05） in 2 groups. There were no difference in ,age, body weight and acquired infection rate in 2 groups. Conclusions The higher PRISM score of the patients, the longer duration of hospitalization and the higher of the mortality. PRISM ,score can predict the severity and prognosis accurately of children in PICU.