PICU内儿童非意外伤害发生情况调查及预后分析  

Study on the prognosis of non-accidental injuries in 59 children admitted in pediatric intensive care unit

作　　者：鲁聪[1] 钱素云[1] 方伯梁[1] 李峥[1] 刘珺[1] 

机构地区：[1]首都医科大学附属北京儿童医院重症医学科,100045

出　　处：《北京医学》2016年第8期798-801,共4页Beijing Medical Journal

摘　　要：目的分析儿童重症监护室收治非意外伤害患儿的流行病学特点及预后。方法回顾分析我院儿童重症监护室2015年1～12月收治的59例非意外伤害（包含虐待、自杀、忽视）儿童的临床特点。结果共纳入患儿59例，男40例，女19例，年龄2个月至16岁。其中婴幼儿40例（68％），学龄前儿童12例（20％），学龄期儿童2例（3％），青春期儿童5例（9％）。本组非意外伤害患儿中，男性患儿（68％，χ2=74，P〈0．001）、婴幼儿期患儿68％，χ3=177，P〈0．001）及农村或务工家庭患儿78％，χ2=62，P〈0．001）所占比例较高。儿童忽视为患儿意外伤害的主要病因（50例，占85％），包含外伤31例，误服药物19例。本组非意外伤害患儿出院28d时总体病死率为20％，出院28d随访致残率为19％。结论儿童非意外伤害存在高病死率及高致残率。男童、婴幼儿、农村及务工家庭来源可能为儿童发生非意外伤害的高危因素。儿童忽视可能是造成儿童非意外伤害的主要原因。应加强对家长，尤其是幼龄儿童家长的安全监护教育，以减少儿童非意外伤害的发生。Objective To analyze the characteristics and prognosis in children with non-accidental injuries admitted to pediatric intensive care unit（PICU）. Methods A retrospective study of 59 children with non-accidental injuries（including physical child abuse, suicide, and child neglect） admitted to PICU from Jan. 2015 to Dec. were carried out. Resuits Fifty-nine patients in total were included. Their age ranged from 2 months to 16 years old, and among them 40 were boys. Infants, preschool, schoolage and adolescent were 40, 12, 2 and 5 cases respectively. Most of them were boys （68%, X2 =74, P 〈 0.001）, and infants（68%, χ2 =177, P 〈 0.001）. Some of the children were from rural workers family （78%, χ2=62, P 〈 0.001）. The main cause of non-accidental injurieswas child neglect（n=50, 85%）, including trauma（n= 31）, and drug poisoning（n=19）. Mortality of the group was 20%, while morbidity was 19%. Conclusion The mortality and morbidity in children with non-accidental injuries is high, especially in boys, infants, and children from rural workers family. Child neglect may be the main cause of non-accidental injury of children. To reduce non-accidental injuries, we should strengthen safety education for parents, especially for young children＇ s parents.

关 键 词：儿童重症监护室 非意外伤害 忽视 虐待 儿童 预后 

分 类 号：R720.597[医药卫生—急诊医学]