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目的分析住院患儿死亡原发疾病谱,探讨如何寻求患儿直接死亡原因及如何规范死亡病例讨论。方法对本院227例死亡病例进行回顾性分析,根据死亡病例的原始病历资料及死亡病例讨论,分析推断直接死因。结果 227例死亡病例中,婴幼儿占总数的70%;PICU 157例(69.2%);原发疾病中前3位是神经系统疾病(颅内感染、肿瘤、出血、外伤)55例(24.2%),先天畸形(先天性心脏病、先天性消化道畸形)53例(23.3%)及呼吸系统疾病(感染、吸入等)47例(20.7%);推断分析出直接死因的病例67例(占29.5%),其中前3位分别是窒息21例、脑疝17例、大出血致失血性休克8例。结论神经系统疾病是危及危重症患儿生命的主要疾病,是目前研究的重点方向;同时死亡病例讨论作为医院核心制度,其核心是寻求直接死因,这需要相关科室参与诊治及抢救医师共同参与,掌握正确并行之有效的分析方法,而寻求直接死因关键在于抓住病情恶化的时间点。
Objective To analyze the primary disease spectrum of death in hospitalized children and discuss how to seek the direct cause of death and how to regulate the death cases. Methods A retrospective analysis was performed on 227 deaths in our hospital. The direct cause of death was analyzed and analyzed according to the original medical records of deaths and death cases. Results Of the 227 deaths, infants and young children accounted for 70% of the total; PICU 157 cases (69.2%); the top 3 primary diseases were neurological diseases (intracranial infection, tumor, hemorrhage and trauma) 55 cases (24.2% ), Congenital malformations (congenital heart disease, congenital gastrointestinal malformations) in 53 cases (23.3%) and respiratory diseases (infections, inhalation, etc.) in 47 cases (20.7%); inferring the direct cause of death in 67 cases 29.5%), of which the first three were asphyxia in 21 cases, cerebral hernia in 17 cases, hemorrhagic hemorrhagic shock in 8 cases. Conclusions Nervous system diseases are the major diseases which endanger the life of critically ill children and are the focus of current research. At the same time, the death cases discussed as the core system of the hospital, the core of which is to seek the direct cause of death, which requires relevant departments to participate in the diagnosis and treatment and rescue physicians, Master the correct and effective analytical methods, and seek direct cause of death lies in seizing the time point of deterioration.