小儿危重病例评分法的应用与分析  

Application and analysis of pediatric critical illness scoring system

作　　者：蔡义记[1] 吴熙[1] 朱绿绮[1] 李翠昌[1] 徐南平[1] 

机构地区：[1]江西省儿童医院PICU,南昌330006

出　　处：《江西医药》2001年第4期241-244,共4页Jiangxi Medical Journal

摘　　要：目的 用新的小儿危重病例评分法评估我院PICU危重患儿病情的严重程度，分析其临床应用价值。 方法 对我院PICU4a来636例危重患儿进行危重病例评分及器官功能衰竭评估，评分值从高分到低分：～100、～90、～80、0～70共4组。依次代表病情非危重、一般危重、危重、极危重。住院期间进行4次评分。其中32例采取与国外PRISM评分法进行对比分析。 结果 首次评分显示：非危重、一般危重、危重、极危重患儿病死率依次为2．04％、9．56％、16．75％、34．44％。各组差异有非常显著意义（P＜0．01），其后各次评分结果与首次评分相似。器官功能衰竭评估：1、2、3及3个以上器官功能衰竭发生率分别为32．7％、25．6％、16．4％、6．3％，其病死率依次为2．9％、15．3％、38．5％、47．5％，差异有非常显著意义（P＜0．01）。非危重、一般危重、危重至极危重患儿多器官功能衰竭（MSOF）的发生率依次为7．1％、34．3％、67．0％、91．1％，差异有非常显著意义（P＜0．01）。 结论 小儿危重病例评分可准确判断病情轻重，分值越低，病情越重，器官功能衰竭数越多，病死率亦越高。Objective To evaluate and analyze the role of the new pediatric critical illness scoring system PCISS in evaluating critically ill children． Methods evaluate the 636 critically ill children admitted to PICU during 4 years with PCISS． Those children were divided into 4 groups which were non critical illness mild critical illness critical illness and severe critical illness NTS according of the score of～100、～90、～80、0～70 respectively． they were evaluated for 4 times during the PICU stay． 32 of 636 were evaluated with prism scoring system simultaneously． Results The first time evaluation demonstrated the mortalities of NTS were in proper order of 2．04％、9．45％、16．75％、and 34．44％ P＜0．01 The evaluations of rest 3 times had the similar results． The morbidities of organ failure were 32．97％、25．6％、16．4％、and 6．3％ according to the number of failure organs of 1、2、3 and more than 3． While the mortalities were 2．9％、15．3％、38．5％ and 47．5％ respectively P＜0．01． The incidences of multiple organ failure MOF of NTS were 7．1％、34．3％、67．0％ and 91．1％ accordinglyP＜0．01． Conclusion The PCISS is practicable in correctly evaluating the situaton of critically ill patients the lower of the PCISS the more organ failures and the higher mortalities of patients．

关 键 词：儿童 危重病 危重病例评分 PICU 多器官功能衰竭 

分 类 号：R720.597[医药卫生—急诊医学] R725.9[医药卫生—儿科]