儿童创伤临床特点及死亡危险因素分析  

Analysis of clinical features and risk factors of death in children with trauma

作　　者：唐慧雯[1] 李筑英[1] 黄玉娟[1] 俞全胜[1] 刘坚[1] 张国琴[1] 

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院急诊科,200062

出　　处：《中国小儿急救医学》2017年第4期292-295,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的分析儿童创伤的临床特点及死亡危险因素，为探索预防措施及降低病死率提供参考。方法回顾性分析2014年4月至2016年3月我院急诊科收治的7936例创伤患儿的临床特点，利用Logistic回归分析对可能引起创伤患儿死亡的危险因素进行分析。结果创伤患儿男性多于女性（1．73：1），外地患儿（5535例）多于本地患儿（2401例）（X2=14．314，P〈0．05）。婴儿期（2024例）和幼儿期（3097例）病例数最多。四肢[41．9％（3324／7936）]和皮肤创伤[38．5％（3058324／7936）]最多见。儿童创伤原因因年龄段不同而有所差异，坠落、跌倒、交通事故是引起儿童创伤的常见原因。存活组1933例、死亡组5例的儿童创伤评分分别为8．53±2．17、3．17±1．29，普通住院组1852例、ICU组86例的儿童创伤评分分别为9．72±1．25、5．23±1．84。休克失代偿、机械通气、Glasgow评分≤7分、儿童创伤评分〈8分是引起创伤儿童死亡的危险因素。结论家长应提高安全意识、加强对儿童的看护、遵守交通规则以降低儿童创伤发生率。临床医生应对休克失代偿、机械通气、Glasgow评分、儿童创伤评分等因素予以足够重视，尽早识别危重患儿，提高抢救成功率。Objective To analyze the clinical features and risk factors of death in pediatric trauma, in order to provide preventing strategies and reduce mortality. Methods A retrospective study of 7 936 trau- matic children admitted to the emergency department of our hospital from April 2014 to March 2016 was con- ducted. We retrospectively summarized the clinical features and Logistic regression analysis was used to ana- lyze the risk factors of death in children with trauma. Results Compared to females, male patients contribu- ted higher percentages（ 1.73：1 ）. There were more migrant children（5 535 cases） than local ones（2 401 ca- ses） （X2 = 14. 314,P 〈0. 05）. Children in infancy stage（2 024 cases） and toddler period（3 097 cases） were more than in the other periods. Limb[41.9% （3 324/7 936）] and skin injuries[ 38.5% （3 058 324/7 936） were the most common. Children trauma causes varied with age, fall, tumble and traffic accidents were com- mon causes of children trauma. Pediatric trauma score of surviving group （ n = 1933 ） , death group （ n = 5 ） , general ward group（n = 1852） and ICU group（n =86） were 8.53 200062 2. 17,3.17 200062 1.29,9.722000621.25,5.23 200062 1.84 ,respectively. Shock decompensation ,mechanical ventilation ,Glasgow coma scale 〈7 and pediatric trauma score 〈 8 were the risk factors which caused the death of trauma. Conclusion Parents should improve the security sense, strengthen the care of children and obey the traffic rules to reduce the rate of children trauma. Clinicians should pay attention to shock decompensation, mechmlical ventilation, Glasgow coma scale and pediatric trauma score in order to identify critically ill patients in early stage and improve the success rate of rescue.

关 键 词：儿童 创伤 危险因素 

分 类 号：R726.5[医药卫生—儿科]