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目的 探讨应用小儿危重病例评分法作为危重患儿转运的指征。方法 对 2 0 0 0年 6月至2 0 0 2年 11月由我院出车接回重症病房的 10 2例患儿 ,按小儿危重病例评分法进行评分 ,按分值高低顺序将患儿分～ 10 0分、～ 90分、～ 80分及～ 70分四组。分析评分值与患儿转归、多器官功能不全的关系。结果 转运病例中主要疾病顺位为支气管肺炎、神经系统疾病 (包括颅内感染、颅内出血、癫痫等 )、小儿肠炎与意外事故等。危重度评分值越低 ,发生损害的器官数量越多 ,病死率越高 ;各系统器官损害中以呼吸系统损害发生率最高 ,其次为心血管系统、神经系统、消化系统、泌尿系统、血液系统。结论 小儿危重病例评分能反映患儿危重度 ,完全适用于基层医院作为危重患儿转运指征 ,建议在一级基层医院评分 <90分者即宜转运 ,对于有条件的二级基层医院评分 <70分者必须转运 ,当评分在～ 80分和～ 90分者经治疗无好转尽早转诊 ,若无条件开展评分者 ,则草案中单项指标可作为转运指征。
Objective To explore the application of critical pediatric score method as an indicator of critical transport in children. Methods From June 2000 to November 2002, 102 cases of intensive care unit diseased out of hospital by our hospital were scored according to the pediatric critical illness score method, and the children Points ~ 10 0, ~ 90 points, ~ 80 points and ~ 70 points in four groups. Analyze the relationship between score and outcome of children and multiple organ dysfunction. Results The main diseases in transit cases were bronchopneumonia, neurological diseases (including intracranial infection, intracranial hemorrhage, epilepsy, etc.), pediatric enteritis and accidents. The lower the critical score, the more organ damage occurs, the higher the case fatality rate. The highest incidence of respiratory damage is in each organ damage, followed by the cardiovascular system, nervous system, digestive system, urinary system, blood system . Conclusion The score of critical illness in children can reflect the severity of children and is completely applicable to the primary hospital as an indicator of transfusion in critically ill children. It is recommended that patients with grading <90 should be transported in Grade I hospitals, and those with Grade II < 70 points must be transshipped, when the score in the ~ 80 points and ~ 90 points were treated as soon as possible after referral no improvement, if unconditionally carry out the score, the draft single indicators can be used as transfusion indications.