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[儿科重症监护病房中的肿瘤患者——7年经验]

[Oncology patients in a pediatric intensive care unit--a 7-year experience].

作者信息

Haase R, Mathony U, Lieser U, Nagel F, Sitka U, Burdach S

机构信息

Universitätsklinik und Poliklinik für Kinder und Jugendmedizin, Zentrum für Kinderheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale.

出版信息

Klin Padiatr. 2003 Jul-Aug;215(4):234-40. doi: 10.1055/s-2003-41399.

Abstract

BACKGROUND

As a result of improved therapeutic and diagnostic modalities the survival rate of children with neoplastic disease has increased dramatically. The consequences of these scientific advances have led to increased malignancy-related critical complications requiring the expertise of intensive care practitioners.

PATIENTS

From all children admitted to the pediatric intensive care unit (PICU) of the Martin-Luther University Halle those with hematologic-oncologic condition were evaluated.

RESULTS

From 4068 PICU admissions 196 (4.8%) oncologic patients were identified. Most of them were admitted for postoperative care, monitoring or intervention. 24 patients were admitted because of severe disease or treatment related complications. 14 out of 24 (58%) patients died on PICU. Mortality was significant higher in a subgroup requiring mechanical ventilation or suffering from sepsis. All patients but two with multi-organ system failure (> or = 2 organs) died.

CONCLUSIONS

Children with neoplastic disease can benefit from pediatric intensive care unit (PICU) support. Successful treatment of life-threatening complications requires a close cooperation of pediatric oncology and PICU. Further studies are necessary to improve therapeutic strategies in oncology patients requiring PICU admission.

摘要

背景

由于治疗和诊断方式的改进,患有肿瘤疾病的儿童存活率显著提高。这些科学进步的结果导致与恶性肿瘤相关的严重并发症增加,需要重症监护从业者的专业知识。

患者

对马丁 - 路德大学哈雷分校儿科重症监护病房(PICU)收治的所有儿童中患有血液肿瘤疾病的儿童进行评估。

结果

在4068例入住PICU的患者中,确定了196例(4.8%)肿瘤患者。他们中的大多数因术后护理、监测或干预而入院。24例患者因严重疾病或治疗相关并发症入院。24例患者中有14例(58%)在PICU死亡。在需要机械通气或患有败血症的亚组中,死亡率显著更高。除两名患有多器官系统衰竭(≥2个器官)的患者外,所有患者均死亡。

结论

患有肿瘤疾病的儿童可受益于儿科重症监护病房(PICU)的支持。成功治疗危及生命的并发症需要儿科肿瘤学和PICU密切合作。有必要进行进一步研究以改善需要入住PICU的肿瘤患者的治疗策略。

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