Gauthier M, Lacroix J, Rousseau E
Can Anaesth Soc J. 1986 Jan;33(1):89-93. doi: 10.1007/BF03010916.
In contrast with neonatal intensive care services, paediatric intensive care units are relatively new; thus, it is not surprising that their clientele has not been well described in the medical literature. In order to better define it, we did a retrospective analysis of 4646 consecutive admissions of children aged between a week and 18 years to a multidisciplinary paediatric intensive care unit over a period of five years (1979-83). This unit belongs to a 700-bed paediatric hospital delivering medical as well as surgical tertiary care. Of the 4646 admissions, 2527 (54.3 per cent) were surgical and 2119 (45.6 per cent) medical. There were multiple diagnoses on admission. Among the most frequent diagnoses were major trauma (9.6 per cent of total), intoxications (4.6 per cent) and congenital cardiopathies in the postoperative phase of a corrective or palliative surgery (tetralogy of Fallot (2.8 per cent), ASD (2.7 per cent), etc.) The global mortality rate was 5.8 per cent (268/4646). Severe infections and cardiopathies, mostly congenital, were responsible for almost half the deaths (24.2 per cent each). This description of patients and problems encountered in a paediatric intensive care unit should facilitate planning for personnel training and can be used to establish guidelines for reducing mortality.
与新生儿重症监护服务不同,儿科重症监护病房相对较新;因此,医学文献中对其服务对象的描述并不充分也就不足为奇了。为了更好地界定这一群体,我们对一家多学科儿科重症监护病房在五年期间(1979 - 1983年)连续收治的4646例年龄在一周至18岁之间的儿童进行了回顾性分析。该病房隶属于一家拥有700张床位的儿科医院,提供医疗和外科三级护理服务。在这4646例收治病例中,2527例(54.3%)为外科病例,2119例(45.6%)为内科病例。入院时存在多种诊断。最常见的诊断包括严重创伤(占总数的9.6%)、中毒(4.6%)以及矫正或姑息性手术后的先天性心脏病(法洛四联症(2.8%)、房间隔缺损(2.7%)等)。总体死亡率为5.8%(268/4646)。严重感染和心脏病,主要是先天性心脏病,几乎占死亡病例的一半(各占24.2%)。对儿科重症监护病房中患者及所遇到问题的这种描述应有助于人员培训规划,并可用于制定降低死亡率的指导方针。