应用小儿危重病例评分法预测婴幼儿重症肺炎的预后

Prognosis prediction in infants and children with severe pneumonia by using pediatric critical illness score

目的：应用国内儿科危重病例评分法（PCIS）评价婴幼儿重症肺炎的患儿的病情危重度,预计病死风险率,探讨死亡相关因素。方法：对2005-01-2012-01PICU的480例住院的婴幼儿重症肺炎进行PCIS评分和资料分析。结果：0~70分属极危重病例,共42例,占8.75%;〉70~80分属危重病例,共120例,占25.0%;〉80~100分属非危重病例,共318例,占66.25%;评分值越低病情越重,患儿病死率越高;住院期间共进行4次评分,病情好转,评分上升,高分值病例数的百分比不断增加;并进行器官功能衰竭的评估,其评分越低,发生多器官功能衰竭的病例越多,累及器官数越多。结论：小儿危重病例评分法可准确判断婴幼儿重症肺炎病情轻重,并对动态观察病情,指导治疗,预测预后有非常重要的作用。

Objective：To employ pediatric critical illness score（PCIS）to evaluate the severity of critical illness in infants and children with severe pneumonia,estimate the risk of death rate and investigate the death of the relevant factors.Method：The severity of illness and clinical features of 480 infants and children with severe pneumonia admitted to PICU were prospectively studied by using pediatric critical illness score（PCIS）from January,2005 to January,2012.Result：There were 42 cases of extremely serious patients with the score of 0~70 and accounted for 8.75%.There were 120 cases of serious patients with the score70~80 and accounted for 25.0%.There were 318 cases of non serious patients with the score70~80 and accounted for 66.25%.The lower the scores,the more severe the disease and the higher the mortality rate.Patients were scored four times during hospitalization. The condition improved and the scores rose.The percentage of patients with high score increased.The organ failure was assessed.The lower the score,the more cases of multiple organ failure occurred and the more organ involved.. Conclusion：PCIS can be used to evaluate the severity of illness in infants and children with severe pneumonia accurately and the dynamic observation of the disease,which had very important role for guiding treatment and predicting prognosis.