关注重症肺炎——兼谈儿童呼吸与危重症医学结合发展的一点思考

Paying attention to severe pneumonia & viewing on the development of integrating pediatric pulmonary and critical care medicine

重症肺炎依然是儿童死亡的重要原因,关注并管理好重症肺炎有助于降低儿童肺炎的病死率,实现《中国儿童发展纲要(2021-2030)》和达到WHO提出的"到2025年疫苗可预防的肺炎零死亡"的目标。为此,儿童重症肺炎领域的一些问题需要引起重视,如过度诊断问题、肺炎病情严重度评估系统的建立及其临床应用、加强利用评价肺部氧合功能的相关指标和掌握不同的呼吸支持技术等。目前,国内外成人呼吸科多有更名为呼吸与危重症医学科,实行呼吸病学与危重症医学的交融式发展模式。儿科呼吸与重症是否应该融合发展,呼吸科与危重症医学科联合模式在儿科的可行性及其前景值得思索并达成共识,以利其在实践中探索发展。

Severe pneumonia is still a main cause of death in children.Playing attention to and better managing severe pneumonia will help reduce fatality of children with pneumonia,realize Children’s Development Program in China( 2021-2030),and achieve the goal of“Ending Preventable Child Deaths from Pneumonia by 2025”proposed by World Health Organization.For this reason,some problems in severe pneumonia of children should be paid attention to,such as over-diagnosis of severe pneumonia in practice,establishment of the illness assessing systems of pneumonia and its clinical application,fostering the use of relevant indicators to evaluate pulmonary oxygenation function,and mastering different respiratory support technologies.At the moment,the adult respiratory department at home and abroad has been renamed as the Department of Pulmonary and Critical Care Medicine( PCCM),developing the integrated model of respiratory and critical care medicine.The consensus should be gained on whether the pediatric PCCM should be developed,whether it is feasible and what its prospect is,in order to facilitate its development in practice.