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目的调查中国儿科重症监护病房(PICU)的基本配置及住院患儿状况。方法应用问卷调查中国25家PICU的基本配置,应用儿童危重病例评分和美国PICU出入院指南,对2004年1月1日至2005年6月30日各PICU29d至14周岁住院患儿均进行为期12个月的危重病例筛选。结果中国25家PICU平均床位数(11.4±8.0)张,呼吸机数(6.1±3.7)台,44.0%(11/25)的PICU能进行中心静脉压监测。收治病例12018例,危重病例60.5%(7269/12018)。危重病例中内科疾病占76.9%(5590/7269),外科疾病占16.8%(1233/7269),其他科室疾病占6.3%(456/7269);平均住院日6.3d;肺炎41.4%(3013/7269),脓毒症9.5%(688/7269),外伤5.5%(397/7269),呼吸衰竭27.6%(2009/7269);行机械通气26.9%(1957/7269),行机械通气>24h17.9%(1300/7269),ARDS1.44%(105/7269)。研究期间,危重病例中病死率为6.7%(485/7269,95%CI:6.1%～7.3%),PICU中病死率为4.0%(485/12018,95%CI:3.7%～4.4%)。主要疾病病死率为1.3%～61.0%,不同PICU间收治患儿及病死率均存在差异。结论中国PICU配置仍处于初级水平,收治患儿标准及危重患儿病死率可能存在差异。
Objective To investigate the basic configuration of the Chinese Pediatric Intensive Care Unit (PICU) and the status of hospitalized children. Methods A questionnaire was used to investigate the basic configuration of 25 PICUs in China. The critical case scores of children and the admission and admission guidelines of the US PICU were used. The period from January 1, 2004 to June 30, 2005 for each PICU from 29 days to 14 years of hospitalization was 12 months. Months of critical screening. Results The average number of beds in China’s 25 PICUs was (11.4±8.0), the number of ventilators was (6.1±3.7), and 44.0% (11/25) of PICUs could monitor central venous pressure. There were 12018 cases treated and 60.5% (7269/12018) of critical cases. In critical cases, medical diseases accounted for 76.9% (5590/7269), surgical diseases accounted for 16.8% (1233/7269), other department diseases accounted for 6.3% (456/7269), average hospital stay was 6.3 days, and pneumonia was 41.4% (3013/7269). ), Sepsis 9.5% (688/7269), Trauma 5.5% (397/7269), Respiratory failure 27.6% (2009/7269), Mechanical ventilation 26.9% (1957/7269), Mechanical ventilation >24h17.9 % (1300/7269), ARDS1.44% (105/7269). During the study period, the mortality in critical cases was 6.7% (485/7269, 95% CI: 6.1% to 7.3%), and the mortality rate in PICU was 4.0% (485/12018, 95% CI: 3.7% to 4.4%). The mortality rate of major diseases was 1.3% to 61.0%. There were differences in the incidence of children and mortality between different PICUs. Conclusions The PICU configuration in China is still at a primary level, and there may be differences in the standard and critically ill children in the treatment of children.