917例儿童死亡病例分析

Analysis of 917 children dead cases

目的分析2005-2014年该院儿科重症监护病房(PICU)病死患儿的临床特征,为提高PICU医疗质量及降低患儿病死率提供重要依据。方法收集2005年1月至2014年12月该院PICU 917例死亡病例的临床资料,分析其年龄、住院时间、死亡时间、转入科室等分布特征,并进行死因分析。结果 2005-2014年该院PICU 917例死亡病例主要死亡原因前10位依次为先天性畸形,传染病,呼吸系统疾病,损伤与中毒,消化系统疾病,肿瘤,症状、体征和临床与实验室异常所见不可归类在他处者,循环系统疾病,神经系统疾病,血液系统疾病。2010-2014年感染性疾病的构成比较2005-2009年降低,非感染性疾病构成比升高,差异有统计学意义(χ~2=26.29,P=0.00),但脓毒血症、手足口病呈上升趋势。结论先天性畸形是该院PICU患儿的第1位死亡原因,降低儿童病死率的关键是减少先天性畸形患儿的出生。

Objective To analyse clinical features of dead children in pediatric intensive care unit（PICU） of Children＇s Hos- pital of Chongqing Medical University from 2005 to 2014. Methods Clinical data of 917 dead cases in PICU from January 2005 to December 2014 in this hospital were collected, then distribution characteristics of age, length of hospital stay, time of dead and transfer department were analysed. The death cause analysis was conducted as well. Results According to systematic classification of disease,the top l0 leading causes of death for 917 dead cases in PICU from 2005 to 2014 in this hospital were congenital deformi- ty, infectious disease, respiratory disease, injury and poisoning, digestive system disease, tumor, symptoms, signs and abnormal clini- cal and laboratory findings not elsewhere classified, circulation system disease, nervous system disease, blood system disease. Com- pared with 2005--2014, the ratio of dead cases due to infectious diseases to the total cases was declined, while that due to non-infec- tious diseases was increased,there was statistically significant difference （X2= 26.29, P= 0.00）. Whereas, the ranks of septicopy- emia and hand-foot-mouth disease in the rank order of death causes both were increased. Conclusion Congenital deformity is the first cause of death in PICU of this hospital. The key to cutting children＇s mortality is to reduce newborn with congenital deformity,