摘要
目的为改善儿科急诊危重患儿的预后及提高其生存率寻找可行途径。方法对我院急诊创伤中心(EDTC)2000年3月～2007年3月经急救绿色通道抢救患儿的临床资料进行分析,并对急救绿色通道的运作模式与质量进行评价。结果本研究共纳入280例患儿,剔除来院已死亡者50例,余230例。其中心肺功能衰竭108例。呼吸衰竭79例,休克43例;在急诊室死亡70例(其中放弃抢救18例)。急诊复苏成功率76.4%;年龄小于1岁169例(占本组病例数的60.4%),死亡83例(占本组死亡数的70.3%)。疾病谱中意外伤害82例(占本组病例数的29.3%),其中死亡41例(占本组死亡数的34.8%)。在EDTC进行"仿真模拟急救"演习。对演习前后医护人员在急救的基本技能、整体配合、综合能力上进行比较,结果显示差异有非常显著性(P<0.01)。结论儿科急诊急救绿色通道能为危重病和创伤儿童提供快速、有效的急诊救治;对EDTC人员进行"仿真模拟急救"演习将对急救绿色通道高水平的运行提供质量保证;加强1岁以下年龄组的保健和加强意外伤害的预防是减少儿科危重患儿发病和死亡的关键。
Objective To explore the feasible methods and policies to improve the prognosis and survival rates of critically ill children. Methods Clinical data analysis was conducted among the patients who accepted first-aid Green Track （GT） resuscitations in our emergency department trauma center （EDTC） from March 2000 to March 2007. Meanwhile, operation mode and quality of first-aid GT were evaluated. Results Two hundred and eighty patients were enrolled and 50 patients died at arrival were excluded, resulting in 230 eligible cases. Among the 230 eligible cases, 79 had respiratory dysfunction or failure, 43 had circulation dysfunction or failure. Seventy patients died in EDTC （ 18 quitted）, with the resuscitation survival rate of 76.4 %. One hundred and sixty-nine patients were younger than 1 year old （with the proportional ratio of 60.4 % ）, among whom 83 patients died. Accidental injuries were found in 82 cases （29.3 %） and 41 cases died. For EDTC doctors and nurses attending basic skill trainings in Pediatric Advanced Life Support （PALS） courses, ＂Mock Code＂ program could integrate various parts of general team resuscitation capacities such as basic concepts, practical skills and cooperative practices. Conclusion GT is effective for the critical and traumatic patients. ＂Mock Code＂ program guarantees the high quality of first-aid GT. Raising the awareness for the health care of children younger than 1 year old and preventing accidental injuries are determinants of decreasing the mobility and mortality of pediatric critically ill patients.
出处
《中国小儿急救医学》
CAS
2007年第6期514-517,共4页
Chinese Pediatric Emergency Medicine
关键词
急救绿色通道
儿科
First-aid green track
Pediatrics
