摘要 目的：总结中国医科大学附属盛京医院PICU 2005~2012年间收治患儿的疾病谱及导致死亡的常见疾病种类，以指导PICU的临床治疗工作。方法：回顾性分析2005~2012年间该院PICU收治的4484例患儿的临床资料。结果：2005~2012年间4484例患儿中，急性支气管肺炎居疾病谱中第1位，占24.51%(1099/4484)；颅内感染、脓毒症、手足口病、外伤等疾病有逐年上升趋势，而非创伤性颅内出血、癫癎、先天性心脏病等疾病呈下降趋势。2005~2012年间病死率呈逐年下降趋势，由2005年的11.5%下降到2012年的3.1%，其中2005~2008年与2009~2012年前后4年病死率比较差异有统计学意义（11.98% vs 4.41%;P<0.01）。急性重症支气管肺炎、重度脓毒症、复杂性先天性心脏病、重度颅脑外伤、呼吸衰竭、重症手足口病、急性中毒、循环衰竭等为患儿主要死因。结论：急性支气管肺炎等感染性疾病是2005~2012年间该院PICU的主要病种，但疾病谱随着时间的变化发生了一些改变。2005~2012年间患儿病死率呈逐年下降趋势，急性重症支气管肺炎、重度脓毒症等为患儿主要死因。
Abstract：OBJECTIVE: To summarize the spectrum of disease and common diseases that cause death in children admitted to the Pediatric Intensive Care Unit (PICU), Shengjing Hospital of China Medical University between 2005 and 2012. METHODS: A retrospective analysis was carried out on the clinical data of 4484 children admitted to the PICU of Shengjing Hospital bettween 2005 and 2012. RESULTS: Acute bronchopneumonia, which was found in 1099 (24.51%) of the 4484 cases, was the most common disease in the PICU bettween 2005 and 2012. The incidence of intracranial infection, sepsis, hand-foot-mouth disease and trauma showed an increasing trend from 2005 to 2012, but that of non-traumatic intracranial hemorrhage, epilepsy and congenital heart disease showed a decreasing trend. The mortality decreased from 11.5% in 2005 to 3.1% in 2012, and the overall mortality was significantly higher in 2005-2008 than in 2009-2012 (11.98% vs 4.41%; P<0.01). The main causes of death included severe acute bronchial pneumonia, severe sepsis, complex congenital heart disease, severe cerebral trauma, respiratory failure, severe hand-foot-mouth disease, acute poisoning and circulatory failure. CONCLUSIONS: Acute bronchopneumonia was the most common disease in the PICU of Shengjing Hospital bettween 2005 and 2012, but the spectrum of disease changed over time. The mortality showed a decreasing trend among the children in the PICU bettween 2005 and 2012, and the main causes of death included severe acute bronchial pneumonia and severe sepsis.
LI Jiu-Jun,CHEN Yan-Fei,LIN Ye-Xin. Investigation of disease spectrum in the PICU of Shengjing Hospital of China Medical University between 2005 and 2012[J]. CJCP, 2013, 15(6): 472-476.
［1］Elliott SR, Beeson JG. Estimating the burden of global mortality in children aged <5 years by pathogen-specific causes［J］. Clin Infect Dis, 2008, 46(11):1794-1795.
［2］World Health Organization (WHO).World Health Statistics［EB/OB］.［2013-03-10］. http://www.who.int.
［3］Ladhani S, Konana OS, Mwarumba S, English MC. Bacteraemia due to Staphylococcus aureus［J］. Arch Dis Child, 2004, 89(6):568-571.
［4］Lautenschlager S, Herzog C, Zimmerli W. Course and outcome of bacteremia due to Staphylococcus aureus: evaluation of different clinical case definitions［J］.Clin Infect Dis, 1993, 16(4):567-573.
［5］Carrol ED, Thomson AP, Hart CA. Procalcitonin as a marker of sepsis［J］. Int J Antimicrob Agents, 2002, 20(1):1-9.
