需经气管插管呼吸支持的急诊小儿发绀26例临床分析

Clinical analysis of 26 cyanosis children who need trachea intubation and respiratory support in emergency treatment

目的探讨儿科急诊中需经气管插管呼吸支持的发绀(cyanosis)病例临床特征。方法总结26例需经气管插管呼吸系统支持的急诊发绀患儿临床及实验室检查特点、诊断,观察其转归。结果除外1例假性发绀,平均年龄4个月,发病至急诊抢救平均时间6天;呼吸困难24例,呼吸停止2例;心动过速21例,心动过缓2例,心跳停止2例,心律不齐1例;除外1例诊断不明,循环系统疾病12例,呼吸系统疾病7例,其他系统疾病6例,其中先天性疾病11例,感染性疾病9例,意外伤害3例,其他病因2例;好转或痊愈出院15例,抢救后机械通气最后死亡5例,当时抢救无效死亡3例,抢救后病情尚未稳定家人放弃进一步治疗自动出院3例。结论需经气管插管呼吸支持的急诊小儿发绀疾病的特点:①年龄小,起病急,进展快,常就诊不及时;②病情重,死亡率高;③循环系统和呼吸系统疾病仍占主要部分,先天性和感染性因素为主要病因;④意外伤害占有一定比例。

Objective To explore the clinical characteristics of the cyanosis children who need trachea intubation and respiratory support in emergency treatment. Methods Summarize the clinical and laboratory examination＇ s characteristics, disease＇ s diagnoses and prognoses of 26 cyanosis children who need trachea intubation and respiratory support in emergency treatment. Results Of the 26 cases, except 1 that was pseudo cyanosis, the average age was 4 months old, the average time from diseases coming on to emergency treatment is 6 days; 24 had dyspnea, 2 had apnea; 21 had tachycardia, 2 had bradycardia, 2 had cardiac arrest; 1 had arrhythmia; excpet t which diagnosis was uncertain, 12 were circulating system diseases, 7 were respiratory system diseases, 6 were other systems＇ diseases; 11 were congenital disease, 9 were infective diseases, 3 were acidents, 2 were other etiological agents; 15 recovered or mended, 5 died after being rescued and mechanical ventilated, 3 died in the rescuing, 3 whose states were not stable after rescuing were given up more treatment by their parents. Conclusion The diseases of cyanosis children who need trachea intubation and respiratory support in emergency treatment have these characteristics： ①The patients are very young, the onsets are acute, and the diseasese worsen fast; ②The diseases are severe, and the mortality is high;③Circulating and respiratory systems＇ diseases are major components, congenital and infective agents are major etiological agents; ④Accidents occupy a certain proportion.