中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2010年
6期
516-518
,共3页
二级综合医院%急诊%医疗模式%ICU
二級綜閤醫院%急診%醫療模式%ICU
이급종합의원%급진%의료모식%ICU
Second class general hospital%Emergency%Medical model%ICU
目的 探讨二级综合医院利用成人ICU设备和护士资源、儿科专科医师管理的救治模式在小儿急救方面的应用.方法 回顾性分析我院近5年来在成人急诊观察区域建立儿科观察室,利用成人急诊ICU设备和护士资源救治具有转运高风险的危重患儿的预后和疾病谱.结果 5年来急诊观察室收治儿科患者5076例次,约占年门急诊量的3.40%.入观患儿中危重者464例,占入观患儿的9.14%,其中转院251例(54.09%),因转运高风险而收住成人急诊ICU 35例(7.54%),14例需要呼吸机支持.其疾病谱主要以儿童意外损害为主,包括创伤、中毒和溺水等,内科疾病主要是严重感染和爆发性心肌炎等.经过止血、呼吸支持、纠正休克、维护重要脏器功能等综合治疗,取得令人满意的效果,痊愈好转率达77.14%,机械通气患儿的存活率>85%.结论 在我国,儿科急诊医疗服务体系还没完善前,基层综合性医院利用优势的成人ICU设备和护理团队,以经培训的儿科医师为主体的危重病救治模式是可行的,符合我国的国情.
目的 探討二級綜閤醫院利用成人ICU設備和護士資源、兒科專科醫師管理的救治模式在小兒急救方麵的應用.方法 迴顧性分析我院近5年來在成人急診觀察區域建立兒科觀察室,利用成人急診ICU設備和護士資源救治具有轉運高風險的危重患兒的預後和疾病譜.結果 5年來急診觀察室收治兒科患者5076例次,約佔年門急診量的3.40%.入觀患兒中危重者464例,佔入觀患兒的9.14%,其中轉院251例(54.09%),因轉運高風險而收住成人急診ICU 35例(7.54%),14例需要呼吸機支持.其疾病譜主要以兒童意外損害為主,包括創傷、中毒和溺水等,內科疾病主要是嚴重感染和爆髮性心肌炎等.經過止血、呼吸支持、糾正休剋、維護重要髒器功能等綜閤治療,取得令人滿意的效果,痊愈好轉率達77.14%,機械通氣患兒的存活率>85%.結論 在我國,兒科急診醫療服務體繫還沒完善前,基層綜閤性醫院利用優勢的成人ICU設備和護理糰隊,以經培訓的兒科醫師為主體的危重病救治模式是可行的,符閤我國的國情.
목적 탐토이급종합의원이용성인ICU설비화호사자원、인과전과의사관리적구치모식재소인급구방면적응용.방법 회고성분석아원근5년래재성인급진관찰구역건립인과관찰실,이용성인급진ICU설비화호사자원구치구유전운고풍험적위중환인적예후화질병보.결과 5년래급진관찰실수치인과환자5076례차,약점년문급진량적3.40%.입관환인중위중자464례,점입관환인적9.14%,기중전원251례(54.09%),인전운고풍험이수주성인급진ICU 35례(7.54%),14례수요호흡궤지지.기질병보주요이인동의외손해위주,포괄창상、중독화닉수등,내과질병주요시엄중감염화폭발성심기염등.경과지혈、호흡지지、규정휴극、유호중요장기공능등종합치료,취득령인만의적효과,전유호전솔체77.14%,궤계통기환인적존활솔>85%.결론 재아국,인과급진의료복무체계환몰완선전,기층종합성의원이용우세적성인ICU설비화호리단대,이경배훈적인과의사위주체적위중병구치모식시가행적,부합아국적국정.
Objective To explore the pediatric emergency medical mode in critical ill children by pediatrics specialty and nurses,using equipments of ICU for adults in second class general hospital. Methods We retrospectively analyzed the effect of establishing the pediatric observation unit in the adult observationdistrict and the prognosis and disease spectrum of pediatric critical patients in our emergency ICU in the past five years. Results 5 076 pediatric patients had been admitted to the emergency observation unit accounting for 3.40% of outpatient yearly. There were 464 critically ill children,accounting for 9. 14% of children into the observation unit,251 cases (54. 09%) were transported to other hospitals,35 cases (7.54%) were admitted to emergency ICU due to transport high-risk, 14 cases required ventilator support. The disease spectrum based mainly on childhood accident,including trauma,poisoning and drowning,etc. The other major diseases were severe infection and fulminant myocarditis. After the treatment such as stopping bleeding, respiratory supporting ,correcting shock, and maintaining the function of important organs,77. 14 % were improved or recovered. The survival rate of children with mechanical ventilation was > 85%. Conclusion In our country,the pediatric emergency medical service system is inadequate. The critical illness treatment model of using the advantages of equipments and nurse' s team of adult ICU in second class general hospital ,combining with pediatrician trained in PICU is feasible and consistents with our national conditions.
