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目的:分析上海市郊区中心医院急诊抢救室儿童病例的发病和诊治特点,探讨上海郊区儿科急诊工作的一些规律。方法:分析2004年1月～2007年12月上海市奉贤区中心医院急诊抢救室接诊的475例14岁以下儿童病例的发病特点、病例资料。结果:4年间急诊抢救室共接诊新生儿47例(9.89%),～1岁74例(15.58%),～3岁170例(35.79%),3岁以上儿童184例(38.74%),婴幼儿为主,占61.26%;神经系统急诊251例(52.84%),占第1位,以惊厥发作为主要表现;意外伤害116例(24.42%),呼吸系统急诊23例(4.84%);死亡109例,病死率22.95%,其中来院死亡95例,占绝大多数,且复苏成功率低;其中新生儿死亡27例(57.45%),以早产儿为主,28天～1岁死亡24例(32.43%),1岁以上死亡58例(16.38%),28天～14岁儿童中死亡原因顺位为溺水/粪32例(39.02%)、车祸伤18例(21.95%);死亡的高发年龄段为新生儿时期,儿童的主要死亡原因为意外伤害,共73例(89.02%)。四季儿童急诊发病率比较差异无统计学意义。结论:上海郊区综合医院儿科急诊病例四季常发;以1岁以上儿童为主;神经系统急诊和意外伤害者较多;死亡病例主要为来院时已死亡,主要死因为意外伤害,新生儿死亡以早产儿为主。加强儿童急救系统建设是提高儿童急救的关键。
Objective: To analyze the incidence and diagnosis and treatment of children’s emergency room in Shanghai Central Hospital, and to explore some laws of pediatric emergency in Shanghai suburbs. Methods: From January 2004 to December 2007 in Shanghai Fengxian District Central Hospital emergency room access 475 cases of children under the age of 14 cases of disease characteristics, case data. Results: 47 cases (9.89%) were newly diagnosed in emergency room during the four years, 74 cases (15.58%) were at 1 year old, 170 cases (35.79%) were at 3 years old and 184 cases (38.74%) were over 3 years old. Infants and young children accounted for 61.26%; 251 cases (52.84%) were emergency department of nervous system, accounting for the first one. Convulsion was the main manifestation; 116 cases (24.42%) were accidental injuries and 23 cases (4.84%) were respiratory emergency cases. Among them, 109 cases were fatal and the case fatality rate was 22.95%. Among them, 95 cases died in the hospital, accounting for the vast majority, and the success rate of recovery was low. Among them, 27 cases were neonatal deaths (57.45%), (32.43%), 58 cases (16.38%) died of over 1 year old, the cause of death in 28 days to 14 years old was 32 cases (39.02%) of drowning / excrement and 18 cases (21.95%) of accidental car accident; The high incidence of neonatal period, the main cause of death of children was accidental injury, a total of 73 cases (89.02%). There was no significant difference in the incidence of emergency among children in four seasons. CONCLUSIONS: The pediatric emergency department in Shanghai suburban general hospital often occurs in four seasons, with more than 1 year old children and more nervous system emergency and accidental injuries. The deaths are mainly from the hospital, with the main cause of death being accidental injury and neonatal death Premature children. Strengthening the construction of children’s first aid system is the key to improving children’s first aid.