我院儿童加强医疗病房脑死亡发生率及临床特点分析

The incidence and the clinical features of brain death in pediatric intensive care unit

目的了解脑死亡在儿童加强医疗病房（ＰＩＣＵ）的发生率并分析其特殊临床表现。方法对１９９４年３月～１９９８年３月ＰＩＣＵ确诊的１４例脑死亡患儿的临床资料进行总结分析。结果脑死亡在ＰＩＣＵ的发生率为０．８７％（１４／１６０４），占总死亡患儿数的１２．１％。原发病以颅内感染为主。中枢性尿崩症、高血糖、低二氧化碳分压的发生率分别为７３％（８／１１）、４３％（６／１３）和５０％（７／１４），两种症状同时出现占６２％（８／１３），三联征同时出现占２７％（３／１１）。结论该院ＰＩＣＵ脑死亡发生率为０．８７％。中枢性尿崩症、高血糖、低二氧化碳分压是部分脑死亡患儿重要的临床表现。

Objective To estimate the incidence of brain death in pediatric intensive care unit (PICU) patients and to analyse some clinical features in the patients. Methods The medical records of 14 cases of brain death admitted to PICU at Beijing Children's Hospital during the years from march, 1994 to march, 1998 were reviewed. Results During the study period, the incidence of brain death was 0.87% (14/ 1 604) in PICU. The most common primary diagnosis was encephalitis. The incidences of central diabetes insipidus, hyperglycemia and low PCO 2 were 73%(8/11), 43%(6/13) and 50%(7/14) , respectively. 62%(8/13) of the patients had two of the three features at the same time, and 27%(3/11) of the patients had all of the three features. Conclusion The incidence of brain death in PICU patients at Beijing Children′s Hospital was 0.87%. Central diabetes insipidus, hyperglycemia and low PCO 2 were important clinical signs in some patients with brain death.