CAJ | 학술논문

近年来我国危重儿病死率逐年下降,但评估疾病严重程度、判断入住重症监护病房标准是一项复杂的工作;采用评分法能够分级评判疾病危重程度,更加客观、有效.目前应用的重症评分很多,儿科领域国外较多采用小儿死亡危险评分,国内更倾向于本土的小儿危重病例评分(PCIS).PCIS在判断病情轻重、评估死亡风险方面取得了极大成功,但由于儿童群体特殊性及国情等,有时分值并不与危重程度一致,还需靠临床症征、治疗效果等方面综合判断.急性生理学及慢性健康状况评分系统(APACHE)、序贯器官衰竭估计评分(SOFA)在儿科领域应用有限,但二者对于疾病危重程度均有相当的效验力,是临床研究的有用工具,如引入儿科可能会有新突破.另外小儿死亡风险评分、小儿死亡指数在我国应用尚不广泛.
근년래아국위중인병사솔축년하강,단평고질병엄중정도、판단입주중증감호병방표준시일항복잡적공작;채용평분법능구분급평판질병위중정도,경가객관、유효.목전응용적중증평분흔다,인과영역국외교다채용소인사망위험평분,국내경경향우본토적소인위중병례평분(PCIS).PCIS재판단병정경중、평고사망풍험방면취득료겁대성공,단유우인동군체특수성급국정등,유시분치병불여위중정도일치,환수고림상증정、치료효과등방면종합판단.급성생이학급만성건강상황평분계통(APACHE)、서관기관쇠갈고계평분(SOFA)재인과영역응용유한,단이자대우질병위중정도균유상당적효험력,시림상연구적유용공구,여인입인과가능회유신돌파.령외소인사망풍험평분、소인사망지수재아국응용상불엄범.
Many PICU and NICU have been gradually established from 80's in China,and the rescueing success rate of critically ill pediatrics is increasing fast.However,to assess the severity of disease and to determine the ICU admission standards is a quite complex job.Using scoring systems to predict hospital mortality in critically ill patients can be more objectively,scientifically and effectively.There are some scoring systems widely used in the world.Hospitals in china use PCIS more and these in foreign prone to PRISM score highly in pediattic field.PCIS was made in china and it achieves great success on the side of risk adjustment and mortality prediction.But pediatrics are special,sometimes the severity of disease is not completely consistent with the prognosis and the differences among individuals cannot be ignored yet,so PCIS have unavoidable limitations.The scoring systems and clinical symptoms and signs and therapeutic effect should be combined to assess the severity of disease more accurately.Acute physiology and chronic health evaluation(APACHE),and sequential organ failure estimation score(SOFA) are rarely used in the field of pediatric applications,but both are useful tools for clinical research,if it can be introduced into the pediatric field,there may be a new breakthrough.Besides,Pediatric Risk of Mortality Score and Pediatric Risk of Mortality are not widely used in our country.