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目的分析急诊死亡患儿的流行病学特点,了解引起儿童急诊死亡的主要疾病谱及其变化趋势。方法回顾性分析2005-2014年重庆医科大学附属儿童医院1 115例急诊死亡病例资料,在城乡分布、年龄、性别、入院死亡时间、死亡地点、季节及原发疾病等方面进行统计分析。结果急诊死亡患儿男女比例为157∶100,农村患儿明显多于城市患儿(城乡比例为1∶2.64)。到院前死亡(death on arrival,DOA)占8.07%。新生儿死亡占37.49%,婴儿占26.10%,≤1岁死亡患儿高达63.59%,是急诊死亡患儿的主要年龄层。急诊死亡患儿以每年1月为高发季节(占13.63%)。急诊死亡前5位疾病分别为肺炎(14.71%)、先天性心脏病(10.40%)、呼吸窘迫综合征(9.24%)、意外伤害(8.70%)和窒息(误吸)(5.11%)。因此呼吸系统疾病占急诊死亡病例的23.95%。近年因意外伤害、手足口病死亡的患儿呈上升趋势。结论 1岁以内患儿是小儿急诊死亡的高危人群,呼吸系统疾病是患儿急诊死亡的主要病因。
OBJECTIVE: To analyze the epidemiological characteristics of children with emergency death and to understand the main disease spectrum and its changing trend in the emergency of children. Methods A retrospective analysis was conducted on the data of 1 115 emergency deaths in Children’s Hospital of Chongqing Medical University from 2005 to 2014. Statistical analysis was made on the distribution of urban and rural areas, age, gender, time of death from hospitalization, place of death, season and primary diseases. Results The male-female ratio of children who died in emergency department was 157: 100. Children in rural areas were significantly more than those in urban areas (urban-rural ratio was 1: 2.64). Death on arrival (DOA) accounted for 8.07%. Neonatal deaths accounted for 37.49%, infants accounted for 26.10%, ≤ 1 year-old children up to 63.59% of deaths, is the main age of emergency death in children. Emergency deaths in children every January in the high season (13.63%). The first five deaths were pneumonia (14.71%), congenital heart disease (10.40%), respiratory distress syndrome (9.24%), accidental injury (8.70%) and asphyxia (aspiration) (5.11%) respectively. Respiratory diseases therefore account for 23.95% of emergency deaths. In recent years due to accidental injury, hand-foot-mouth disease in children is on the rise. Conclusions Children within 1 year of age are the highest risk of death from pediatric emergency. Respiratory diseases are the major causes of emergency death in children.