论文部分内容阅读
目的:分析PICU严重创伤患儿的临床特点及死亡危险因素，为制定预防措施及降低病死率提供科学依据。方法:对2015年1月至2019年10月在中国医科大学附属盛京医院PICU的177例严重创伤患儿进行回顾性分析。将其依据预后分为死亡组及存活组。分析两组临床特征的差异，并应用Logistic多因素回归分析影响预后的危险因素。结果:177例创伤患儿中，1～3岁54例；男104例；69例在7～9月份发生创伤。89例因机动车造成交通意外伤，151例存在头部创伤，105例出现了多发伤。死亡组和存活组之间的住院天数、ISS评分、Glasgow昏迷评分、机械通气需求、乳酸、pH值、碳酸氢盐、血糖、白细胞计数、血红蛋白及红细胞压积存在差异(n P<0.05)。Logistic回归分析提示机械通气需求(n OR＝0.029，95%n CI 0.004～0.241)及Glasgow昏迷评分(n OR＝1.321，95%n CI 1.121～1.557)是创伤预后的主要影响因素。n 结论:男童发生创伤率较高，年龄1～3岁、7～9月份为儿童创伤高峰期，机动车造成的交通意外伤最多见，创伤部位以头部最常见。儿童创伤的预后与性别、年龄、时间、病因、损伤部位有关，机械通气需求率及Glasgow昏迷评分是死亡的危险因素。“,”Objective:To analyze the clinical characteristics and death risk factors of children with severe trauma in PICU.To provide scientific basis for formulating preventive measures and reducing mortality.Methods:The clinical data of the children who were diagnosed with trauma in PICU at Shengjing Hospital of China Medical University from January 2015 to October 2019 were analyzed retrospectively.All of them were divided into death group and survival group.The differences of clinical characteristics between two groups were analyzed, the prognostic risk factors were analyzed by Logistic multivariate analysis.Results:Of the 177 children with trauma, 54 were in the 1-3 age group and 104 were male.Sixty-nine children suffered trauma from July to September.Eighty-nine cases were injured in traffic accidents caused by motor vehicles.One hundred and fifty-one cases occured head trauma.One hundred and five children suffered multiple injuries.There were significant differences in hospitalization days, ISS score, Glasgow coma score, mechanical ventilation requirements, lactic acid, pH, bicarbonate, blood glucose, white blood cell count, hemoglobin, and hematocrit between death group and survival group(n P<0.05). Logistic regression analysis suggested that the demand for mechanical ventilation(n OR=0.029, 95% n CI: 0.004~0.241)and Glasgow coma score(n OR=1.321, 95% n CI: 1.121~1.557)were independent risk factors for the prognosis of trauma(n P<0.05).n Conclusion:Boys have a higher incidence of trauma.The peak trauma period for children is from 1 to 3 years old and from July to September.Traffic accidents caused by motor vehicles are the most common reason and head injuries are the most common in trauma sites.The prognosis of trauma in children is related to gender, age, time, etiology, and injury site.The demand rate of mechanical ventilation and Glasgow coma score are risk factors for death.