2022 年第 1 期 第 17 卷

小儿危重病例评分法对儿童重症监护病房患儿的评估效果

Evaluation effect of pediatric critical illness score on children in pediatric intensive care unit

作者：罗永田孙慧蒋支贵

英文作者：Luo Yongtian Sun Hui Jiang Zhigui

单位：贵州医科大学附属医院儿童重症监护病房，贵阳550004

英文单位：Pediatric Intensive Care Unit Affiliated Hospital of Guizhou Medical University Guiyang 550004 China

关键词：小儿危重病例评分；儿童；重症监护；临床应用

英文关键词：Pediatriccriticalillnessscore;Children;Intensivecare;Clinicalapplication

• 摘要：

• 目的 分析小儿危重病例评分法（PCIS）对儿童重症监护病房（PICU）患儿的评估效果。方法 回顾性分析2017年1月至2020年12月贵州医科大学附属医院收治的1 546例患儿的临床资料。记录患儿入住PICU主要疾病（第一顺位）。所有患儿入院24 h内完成PCIS评分，入院48 h、出科时再次评分。比较不同评分患儿脏器损害数、机械通气时间、PICU住院时间、PICU住院费用和预后情况。结果 入住PICU患儿主要疾病（第一顺位）包括重症肺炎604例（39.1%）、休克306例（19.8%）、严重脓毒症128例（8.3%）等。入院PCIS评分越低的患儿发生脏器损害数越多，机械通气比例越高，机械通气时间越长，差异有统计学意义（均P＜0.05）。入院48 h及出科PCIS评分＞80分患儿比例明显高于入院PCIS评分＞80分患儿，差异有统计学意义（P=0.001）。入院PCIS评分≤70分患儿PICU住院时间长于/PICU住院费用高于71~80分、＞80分患儿［5.00（2.00,11.00）d比5.00（2.25,8.00）、3.00（2.00,5.00）d，2.28（1.07,4.50）万元比1.50（0.85,2.69）、1.10（0.74,1.68）万元］，差异均有统计学意义（均P=0.001）。入院PCIS评分越低，自愿出院率及病死率越高，差异有统计学意义（P＜0.05）。结论  PCIS能对PICU患儿病情及转归做出判断，为危重患儿的救治提供帮助。

• Objective   To analyze the evaluation effect of pediatric critical illness score (PCIS) on children in pediatric intensive care unit (PICU). Methods  Clinical data of 1 546 children admitted to Affiliated Hospital of Guizhou Medical University from January 2017 to December 2020 were retrospectively analyzed. The major diseases (first order) associated with the children′s admission to the PICU were recorded. All children were performed by PCIS within 24 h after admission, and were performed at 48 h after admission and discharge from PICU. The number of organ damages, duration of mechanical ventilation, length of PICU stay, cost of PICU stay and prognosis were compared among different PCIS. Results  The major diseases (first order) associated with the children′s admission to the PICU were severe pneumonia 604 cases (39.1%), shock 306 cases (19.8%), severe sepsis 128 cases (8.3%) and so on. The PCIS on admission was lower, the number of organ damages was greater, the rate of mechanical ventilation was higher and the time of mechanical ventilation was longer(both P<0.05). The rate of children with PCIS>80 at 48 h after admission and discharge from PICU was higher than that of children with PCIS>80 on admission(P=0.001).The length/cost of PICU stay of children with PCIS≤70 on admission was longer/higher than that of children with PCIS as 71-80 and PCIS>80［5.00（2.00,11.00）d vs 5.00（2.25,8.00）, 3.00（2.00,5.00）d; 22.8（10.7,45.0）thousand yuan vs 15.0（8.5,26.9）, 11.0（7.4,16.8）thousand yuan］(both P=0.001). The PCIS on admission was lower and the rates of voluntary discharge and death were higher(P<0.05). Conclusion  The PCIS can judge the condition and outcome of the children in PICU, and provide help for the treatment of critical children.