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Prospective multicenter survey of children with acute respiratory distress syndrome in 25 pediatric intensive care units in china
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF EMERGENCY MEDICINE
- Issue:
- 6
- DOI:
- 10.3760/j.issn:1671-0282.2005.06.003
- Key Word:
- 儿童;急性呼吸窘迫综合征;患病率;病死率;流行病学
Abstract： 目的调查我国儿科重症监护病房(PICU)急性呼吸窘迫综合征(ARDS)的患病率、原发病、病死率及其影响因素.方法应用小儿危重病例评分和美国PICU入出院指南对2004年1月1日至2004年12月31日期间国内25家儿童医院及某些三级甲等医院的PICU中29 d至14周岁院患儿进行危重病例筛选;应用1994年美欧标准对ARDS病例进行诊断.结果此次研究共有危重病例6 839例,其中ARDS 97例,病死61例,患病率1.42%,病死率、24 h及24h后病死率分别为62.9%、23.7%、51.4%;占同期PICU病死率的13.1%,死亡相对危险性是PICU平均水平的9.3倍.肺炎(54.6%)、败血症(22.7%)为ARDS最常见的原发病.小于1岁起病者40例(41.2%),显著高于其他年龄段(P＜0.01),ARDS起病距原发病出现时间为(75.6±53.0)h,其第25、50、75、90、95百分位分别为24、72、120、144、168 h.起病距入PICU时间小于24 h者59例,占60.8%.ARDS存活者人均住院费用为危重病例的4.5倍.结论小儿ARDS是PICU中的低患病率、高病死率、高疾病负担的危重症,起病原因多为肺炎和败血症.确诊24h内的ICU救治是提高ARDS存活率的关键之一.
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