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題 名 | Shock in the Pediatric Emergency Service: Five Years' Experience=小兒急診之休克病人:五年回顧 |
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作 者 | 張濱; 許宏遠; 張美惠; 林芳郁; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷 期 | 40:1 民88.01-02 |
頁 次 | 頁9-12+57 |
分類號 | 417.512 |
關鍵詞 | 休克; 小兒急診; 預後危險因子; Shock; Pediatric emergency service; Risk factors; |
語 文 | 英文(English) |
中文摘要 | 休克是小兒死亡的重要原因之一。本研究之目的為回溯性分析小兒急診之非受創 性休克病人的病因及預後因素。研究對象為自 1992 年 10 月 1 日至 1997 年 9 月 30 日 止,於本院小兒急診就醫之非受創性休克病人。共 22 名病人為研究對象,包括 11 名敗血 性休克 (50%),7 名低血容積性休克 (32%) 及 4 名心因性休克 (18%) 病人。 病人年齡分 佈從 2 個月至 19 歲。這 22 名病人中,14 名病 (64%) 有潛在性之疾病。 革蘭氏陰性敗 血症 (6/11,55%), 急性腸胃炎 (7/7, 100%),及擴張性心肌病變 (2/4,50%) 分別為敗 血性休克,低血容積性休克,及心因症性休克之最常見原因。 總共 12 名病人 (55%) 死亡 。 死亡率以敗血性休克 (9/11,82%) 及心因性休克 (3/4,75%) 病人為高。低血容積性休 克病人則無人死亡。 影響病人預後的危險因子包括血小板低下及凝血時間 (prothrombin time, partial thromboplastin time) 廷長。 而如果病人小於兩歲或有白血球低下及較高 之 C- 反應蛋白 (C-reactive protein) 值之情況,則伴有較高死亡率之傾向。 |
英文摘要 | We undertook a retrospective study of the risk factors determining outcome of nontraumatic patients with shock in the pediatric emergency service. From October 1992 through Septemper 1997, 22 Patients with the diagnosis of shock were identified, including 11 with septic shock (50%), 7 with hypovolemic shock (32%) and 4 with cardiogenic shock (18%). Their age ranged from 2 months to 19 years old. Among the cases, 14 patients (64%) had other underlying diseases. Gram-negative bacterial sepsis (6/11, 55%), dilated cardiomyopatly (2/4, 50%) and acute gastroenteritis (7/7, 100%) were the most frequent causes of septic, cardiogenic and hypovolemic shock, respectively. In total, 12 patients (55%) died. The mortality rate was high in septic shock (9/11, 82%) and cardiogenic shock patients (3/4, 75%), but low in hypovolemic shock patients (0/7, 0%). The risk factors of poor outcome in patients with shock included thrombocytopenia, prolonged prothrombin time and partial thromboplastin time. Patients with leukopenia, a higher level of C-reactive protein, or under 2 years of age tended to have poor outcom. |
本系統中英文摘要資訊取自各篇刊載內容。