院前危重症患儿专科急救转运系统的临床应用

Clinical application of specialized emergency transport system in critically ill children

目的探讨院前危重症患儿专科急救转运系统的临床应用效果。方法回顾性分析2007年1月至2015年12月于我院重症医学科接诊的2 835例危重症患儿的临床诊治资料,其中转运系统应用前(2007年1月至2010年12月)401例,转运系统应用后(2012年1月至2015年12月)2 434例。对比分析转运系统应用前后患儿疾病类别构成、转运方法构成、死亡率及诊治后的去向构成,分析转运系统临床应用的效果。结果转运系统应用前后疾病构成比例较高的前三位均为新生儿疾病、呼吸系统疾病和神经系统疾病,疾病类别构成比较差异均无统计学意义(P>0.05),采用方法 1转运的比例为35.00%,明显提高于应用前的17.96%,差异有统计学意义(P<0.05);转运前,患儿死亡率为5.99%,明显高于转运后的3.00%,两组比较差异有统计学意义(P<0.05);转运前,回家和门诊治疗最多,占39.90%,其次是转院27.93%,入院17.46%,留院观察最少,仅14.71%;转运后,留院观察最多,占40.47%,其次是入院37.96%,回家和门诊治疗19.60%,而转院最少,仅1.97%,两组比较差异均有统计学意义(P<0.05)。结论院前危重症患儿专科急救转运系统有利于危重症患儿的救治,降低其死亡率,值得临床推广应用。

Objective To investigate the clinical application of specialized emergency transport system in critically ill children. Methods Clinical diagnosis and treatment data of 2,835 critically ill children in our hospital from January 2007 to December 2015 were retrospectively analyzed. The patients were divided into two groups, before application of transport system(January 2007 to December 2010, n=401), after application of transport system(January 2012 to December 2015, n=2,434). Before and after the application of the transport system, the composition of diseases, the proportion of the transport method, the mortality rate and the results after diagnosis and treatment were analyzed, and the effect of the clinical application of the transport system was analyzed. Results The top three disease types before and after the application of the transport system were neonatal diseases, respiratory system diseases, and nervous system diseases. There were no significant difference in the composition of disease types(P>0.05). The proportion of the transport method 1(by ambulance transport) was 35.00%, which was significantly higher than that of before application of transport system(17.96%), and the difference was statistically significant(P<0.05). The mortality rate before application oftransport system was 5.99%, which was higher than that after application of transport system(3.00%), and the differences were statistically significant(P<0.05). Before application of transport system, back home and outpatient treatment accounted for 39.90%, followed by transferred to other hospitals(27.93%), admission(17.46%), stay in hospital for observation(14.71%). After application of transport system, stay in hospital for observation accounted for 40.47%, followed by admission(37.96%), back home and outpatient treatment(19.57%), transferred to other hospitals(2.00%).The differences were statistically significant between(P<0.05). Conclusion Pre-hospital specialized emergency transport system is conducive to the treatment of critically ill children, which can reduce the mortality rate. It is worthy of clinical application.