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中国小儿急救医学
中国小儿急救医学

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中国小儿急救医学/Journal Chinese Pediatric Emergency MedicineCSTPCD
查看更多>>中华医学会主办。本刊是国内儿科领域中惟一一本反映危重症急救方面的国家级儿科专业学术期刊。为中国科技论文统计源期刊，中国科技类核心期刊。杂志主要读者群为全国各级医院的儿科医生，尤其是从事儿科危重症急救方面的临床医生。杂志的栏目有专题讨论、论著、 临床应用研究、综述、讲座、儿科急诊室、 继续医学教育园地、 教学查房、临床病理（例）讨论、短篇报道等。本刊现已被国际权威检索系统俄罗斯《文摘杂志》、美国《化学文摘》、波兰《哥白尼索引》、美国《乌利希国际期刊指南》列为来源期刊 ，并被国内《中国科技论文与引文数据库》（CSTPCD）等多家数据库收录。
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    不忘初心 履践致远

    刘春峰
    1页
    查看更多>>摘要：龙年好景，春在千门万户中。值此辞旧迎新之际，我谨代表《中国小儿急救医学》编辑部全体向无私奋斗在临床一线的儿科同道们，向长期以来关心和支持本刊发展的广大读者、作者、专家们，致以新年的问候和美好的祝愿！
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    儿童病毒性脓毒症——我们不应该忽视的问题

    刘春峰林楠
    2-7页
    查看更多>>摘要：病毒性脓毒症是一种常被忽略的异质形式的脓毒症，可由多种病毒引起。婴幼儿是病毒性脓毒症的高危人群，与婴幼儿免疫力相对低下有关。病毒性脓毒症在致病机制、临床表型、治疗策略等方面有别于细菌感染，有效清除病毒并根据不同的免疫类型进行免疫调节可能对改善预后有益。 Viral sepsis is an often neglected heterogeneous form of sepsis，which can be caused by a variety of viruses.Infants and young children are at high risk of viral sepsis，which is related to their relatively low immunity.Viral sepsis is different from bacterial infection in terms of pathogenesis，clinical phenotype,and treatment strategy.Effective elimination of virus and immune regulation according to different immune types may be beneficial to improve the prognosis.

    病毒脓毒症儿童

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    脓毒症内表型——随时间和空间变化

    王春霞张育才林楠
    8-13页
    查看更多>>摘要：脓毒症异质性是影响其临床疗效和预后的关键因素。多组学技术和整合功能生物学发展促进了机器学习和智能算法在脓毒症异质性内在分子机制的研究，经转录组、蛋白质组、表观遗传组以及外泌体特征谱等多角度分析，提出了脓毒症内表型概念，使脓毒症可以分为临床亚型、代谢亚型、免疫亚型等。脓毒症内表型认知逐步拓展至诊断、危重度评估、临床研究患者筛选、个体化诊疗等多个层面，为脓毒症精准干预带来新思路。 The heterogeneity of sepsis plays critical roles in determining the response of clinical intervention and the outcome of sepsis.Based on the host-response revealed from multiomics,the new idea of the endotype of sepsis was revealed from multiple perspectives,such as transcriptome,proteome,epigenome,and exosome signature spectrum,etc.In recent years,in the field of sepsis endotype,the research of clinical subtype,metabolic subtype,and immune subtype is booming.This concept has gradually penetrated into multiple aspects,including the diagnosis,severity assessment,patients screening for clinical research,and the reference for individualized clinical treatment.It brings a new perspective for clinical individualized treatment of sepsis.

    脓毒症异质性内表型多组学

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    脓毒症与噬血细胞综合征——同与不同

    袁义刘铜林林楠
    14-18页
    查看更多>>摘要：脓毒症为感染引发机体反应失调、全身炎症反应，导致器官功能障碍。噬血细胞综合征为各种病因作用下机体免疫调节异常引发过度炎症反应、炎症风暴、器官功能障碍。二者相似的是均为失调的过度炎症反应，不同的是免疫细胞及细胞因子的活化谱存在差异。前者病因为感染，后者病因包括基因异常、感染、风湿免疫病、恶性肿瘤等。前者为全身炎症反应，后者为极强的高炎症状态。前者抗感染治疗是关键，后者除病因治疗外，免疫抑制治疗非常重要。除休克外，中枢神经系统受累是重要死因，二者均应加强神经功能监护。 Sepsis is dysregulated host response caused by infection leading to systemic inflammation and organ dysfunction.Hemophagocytic lymphohistiocytosis（HLH）could be caused by multiple factors，leading to abnormal immune regulation and resulting in inflammatory storm and organ dysfunction.Their pathogenesis is similar that dysregulated strong inflammatory response developing in the body，but different in activation profiles of immunologic cells and cytokines.Sepsis is caused by infection，while the etiology of HLH includes various conditions such as genetic defects，infection，rheumatic disease，malignancies，etc.There are differences in the degree of inflammation between the two diseases，with sepsis being systemic inflammation and HLH being extremely strong hyperinflammation.Anti-infection is the key to the treatment of sepsis，while immunosupressive measures are essential for HLH except for etiological treatment.Besides shock，central nervous system involvement is significant cause of death，and neuromonitoring should be applied aggressively.

    脓毒症噬血细胞综合征全身炎症反应综合征细胞因子风暴器官功能障碍

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    儿童脓毒性休克血管活性药物的应用——与成人的异同

    李婧文靳有鹏林楠
    19-23页
    查看更多>>摘要：脓毒性休克作为危重患者的重要死因之一，一直是重症医学领域的研究热点。血管活性药物的正确合理应用是脓毒性休克的重要救治措施。因儿童与成人脓毒性休克的血流动力学改变不同，故其血管活性药物的最佳选择亦存在诸多不同。本文就目前脓毒性休克儿童及成人中血管活性药物应用的异同点进行归纳和总结，以期为临床实践提供参考。 As one of the important causes of death in critically ill patients，septic shock has always been the focus of research in the field of critical care medicine.Correct and rational use of vasoactive drug is an important treatment for septic shock.The hemodynamic changes of septic shock in children and adults are different，which lead to the different use of vasoactive drugs.This review summarized the similarities and differences of the application of vasoactive drugs between children and adults with septic shock，thus could provide a reference for clinical practice.

    脓毒性休克血管活性药物儿童成人

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    脓毒症诱导的血小板减少相关多器官衰竭

    张铁凝刘春峰杨妮林楠...
    24-27页
    查看更多>>摘要：脓毒症诱导的血小板减少相关多器官衰竭（TAMOF）是脓毒症相关器官功能障碍的严重亚型之一，具有较高的病死率及不良预后，临床表现特点为感染引起的新发血小板减少和多器官功能障碍。脓毒症诱导的TAMOF发病机制尚未清楚，研究显示血管性血友病因子裂解酶ADAMTS-13在TAMOF发病过程中可能发挥了重要作用。血浆置换治疗似乎有良好的前景，但需大样本随机对照试验来验证，针对血管性血友病因子和ADAMTS-13靶点研发单一治疗药物是未来治疗方向。 Sepsis-induced thrombocytopenia-associated multiple organ failure（TAMOF）is a severe subtype of sepsis-related organ dysfunctions，which has high mortality and poor prognosis.The main clinical characteristics are thrombocytopenia caused by infection and multiple organ dysfunction.However，the exact molecular mechanism of TAMOF remains unclear.The current studies have shown ADAMTS-13，which is a von Willebrand factor lyase，plays an important role during the disease.Plasma exchange could be a treatment method，but still need more large-scale randomized controlled trials to verify.In the future，von Willebrand factor and ADAMTS-13 could become the therapeutic targets for new drug development.

    脓毒症血小板减少脓毒症诱导的血小板减少相关多器官衰竭

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    儿童重症监护病房血液病/恶性肿瘤合并脓毒症患儿病原及耐药分析

    康亮亮武宇辉赫南南陈华保...
    28-34页
    查看更多>>摘要：目的 探讨儿童重症监护病房（PICU）血液病/恶性肿瘤合并脓毒症患儿病原分布特点及耐药情况。 方法 回顾性分析2016年1月至2023年8月中国医科大学深圳市儿童医院PICU住院有明确病原的血液病/恶性肿瘤合并脓毒症患儿的病历资料。根据脓毒症28 d结局分为存活组及死亡组。 结果 纳入176例患儿，发生脓毒症202次，血流感染144例次（71.3%），肺部感染59例次（29.2%），腹部感染21例次（10.4%），软组织感染9例次（4.5%），神经系统感染9例次（4.5%），泌尿系统感染3例次（1.5%）。共确定病原菌244株，革兰阳性菌74株（30.3%）：前3位分别是凝固酶阴性葡萄球菌（21株）、金黄色葡萄球菌（19株）、肺炎链球菌（13株）；革兰阴性菌122株（50.0%）：前3位分别是肺炎克雷伯菌（33株）、大肠埃希菌（25株）、铜绿假单胞菌（23株）；真菌48株（19.7%）：前3位分别是热带念珠菌（14株）、白色念珠菌（10株）、曲霉菌属及耶氏肺孢子菌（均为7株）。死亡组患儿的鲍曼不动杆菌、嗜麦芽窄食假单胞菌及铜绿假单胞菌检出比例均高于存活组[9.0%（6/67）比2.3%（4/177），χ2＝3.971，P＝0.046；9.0%（6/67）比1.1%（2/177），χ2＝7.080，P＝0.008；16.4%（11/67）比6.8%（12/177），χ2＝5.288，P＝0.021]。57例患儿标本同时送检培养及宏基因组学二代测序（mNGS）技术测定：25例培养和mNGS均检测出病原；30例mNGS检测阳性但培养阴性；2例培养阳性但mNGS检测阴性。多重耐药菌感染79株（46.8%）：革兰阳性菌27株（34.2%）、革兰阴性菌52株（65.8%）。174例次（86.1%）脓毒症患儿在发热24 h内接受了经验性抗感染药物治疗。124例次（61.4%）初始经验性抗生素治疗正确覆盖了感染病原菌种类，40例次（19.8%）未覆盖，10例次（5.0%）覆盖不全。22例次（10.9%）尽管覆盖了病原菌种类，但药敏显示对初始抗生素耐药。51例患儿死亡。 结论 入住PICU的血液病/恶性肿瘤合并脓毒症病原菌以革兰阴性菌为主，其次为革兰阳性菌和真菌。多重耐药菌感染比例高。早期识别并结合本地区的病原学分布及耐药情况，经验性选择合理抗感染治疗策略，有助于提高救治成功率。 Objective To explore the distribution characteristics and antibiotic resistance of pathogen in children with hematological disorders and cancers complicated with sepsis in pediatric intensive care unit (PICU). Methods The clinical data of children with hematological disorders and cancers complicated with sepsis hospitalized at Shenzhen Children′s Hospital affiliated to China Medical University from January 2016 to August 2023 were retrospectively analyzed. Patients were divided into survival group and death group based on the outcome of sepsis on 28 days after diagnosis. Results A total of 202 sepsis episodes occurred in 176 children were enrolled in this study. Among all, 144 (71.3%) cases of bloodstream infection, 59 (29.2%) cases of pulmonary infection, 21 (10.4%) cases of abdominal infection, 9 (4.5%) cases of soft tissue infection, 9 (4.5%) cases of nervous system infection, and 3 (1.5%) cases of urinary tract infection. A total of 244 pathogenic strains were identified, in which 74 (30.3%) cases were gram-positive bacteria. The top 3 pathogens isolated were Coagulase negative Staphylococcus (21 strains), Staphylococcus aureus (19 strains) and Streptococcus pneumoniae (13 strains). Gram-negative bacteria accounted for 122 (50.0%) strains, in which top 3 were Klebsiella pneumonia (33 strains), Escherichia coli (25 strains), and Pseudomonas aeruginosa (23 strains). Fungi comprised 48 (19.7%) strains:the top 3 were Candida tropicalis (14 strains), Candida albicans (10 strains), Aspergillus and Pneumocystis jirovecii (7 strains each). The incidence of Acinetobacter baumannii, Stenotrophomonas maltophilia, and Pseudomonas aeruginosa were significantly higher in death group compared to survival group[9.0%（6/67）vs. 2.3%（4/177）, χ2＝3.971，P＝0.046 9.0%（6/67）vs. 1.1%（2/177）, χ2＝7.080，P＝0.008 16.4%（11/67）vs. 6.8%（12/177）, χ2＝5.288，P＝0.021]. The samples of 57 cases were simultaneously detected by both culture and metagenomic next-generation sequencing (mNGS). Pathogens were detected in 25 cases by both culture and mNGS. In 30 cases, pathogen detection were mNGS positive but culture negative. Two cases showed positive results only with culture. A total of 79 (46.8%) strains were multi-drug resistant bacteria, including 27 (34.2%) strains of gram-positive bacteria and 52 (65.8%) strains of gram-negative bacteria. A total of 174 (86.1%) children with sepsis received empirical anti-infective drugs within 24 hours of fever onset. A total of 124 (61.4%) cases were appropriately covered by the initial empirical antibiotics, while 40 (19.8%) cases were not adequately covered and 10 (5.0%) cases had incomplete coverage. Despite the inclusion of pathogenic in the coverage, resistance to initial antibiotics was observed in 22 (10.9%) cases. Fifty-one patients died. Conclusion The predominant pathogens responsible for sepsis in PICU with hematological disorders and cancers is gram-negative bacteria, followed by gram-positive bacteria and fungi. In comparison to healthy children with sepsis, there is a higher incidence of fungal infections among hematological disorders and cancers. The proportion of multi-drug resistant bacteria infection is high. Early identification and combination of local etiological distribution and drug resistance, along with the empirical selection of appropriate anti-infection treatment strategies, can greatly enhance survival rate.

    儿童重症监护病房脓毒症血液病肿瘤病原

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    肠组织氧饱和度和粪便钙卫蛋白对早产儿坏死性小肠结肠炎诊断效能和病情严重性的评估

    方凌毓陈江滨刘志勇王赫...
    35-40页
    查看更多>>摘要：目的 测量肠组织氧饱和度（rSO2）和粪便钙卫蛋白水平，探讨其在早产儿坏死性小肠结肠炎（NEC）发生和病情严重性的诊断价值。 方法 采用前瞻性观察性研究，选取2019年10月至2022年12月泉州市儿童医院收治的早产儿，在诊断NEC 2 h内监测肠rSO2，以及进行粪便钙卫蛋白测定。 结果 纳入NEC及非NEC患儿各30例，内科NEC 14例，外科NEC 16例，死亡患儿8例。NEC组患儿肠rSO2低于非NEC组[49（30，60）% 比 66（60，69）%]，钙卫蛋白水平高于非NEC组[479（297，886）μg/g比203（113，275）μg/g]，差异均有统计学意义（P均＜0.01）。外科NEC组肠rSO2低于内科组，死亡组低于存活组，差异均有统计学意义（P均＜0.01），但钙卫蛋白未发现类似差异。ROC 曲线分析显示，肠rSO2及粪便钙卫蛋白联合诊断NEC的曲线下面积为0.91（95%CI 0.80 ~0.97）最大，其敏感度和特异度分别为73%和100%。当肠rSO2最佳截断值为31%时，预测NEC死亡的曲线下面积为0.99，敏感度100%，特异度95%。 结论 肠rSO2和粪便钙卫蛋白能有效识别NEC的发生，二者联合检测可以提高对新生儿NEC的诊断效能。肠rSO2可以对NEC的严重程度有良好预测，而不是粪便钙卫蛋白。 Objective To evaluate the diagnostic value of intestinal regional oxygen saturation（rSO2）and fecal calprotectin in the occurrence and severity of necrotizing enterocolitis（NEC）in premature infants. Methods A prospective observational study was conducted among premature infants admitted to Quanzhou Children's Hospital from October 2019 to December 2022. Intestinal rSO2 was monitored within two hours of diagnosis of NEC，and fecal calprotectin was measured. Results A total of 60 patients were included, including 30 cases with NEC and 30 cases without NEC, 14 cases of medical NEC, 16 cases of surgical NEC, and eight infants died due to NEC. Infants with NEC had lower intestinal rSO2 [49（30，60）% vs. 66（60，69）%] and higher calprotectin levels [479（297，886）μg/g vs. 203（113，275）μg/g] than those in infants without NEC (P<0.01). The levels of intestinal rSO2 were lower in surgical NEC than those in medical NEC，and were lower in the death group than that in the survival group (P<0.01)，but no similar difference was found in the levels of calprotectin. ROC curve analysis showed that intestinal rSO2 combined with calprotectin had a sensitivity of 73%，a specificity of 100%，and the largest area under curve of 0.91 in the diagnosis of NEC. Intestinal rSO2 had an optimal cut-off value of 31% in predicting death in infants with NEC，with a sensitivity of 100%，a specificity of 95%，and an area under curve of 0.99. Conclusion Intestinal rSO2 and fecal calprotectin can effectively identify the presence of NEC，and their combined detection can improve the diagnostic efficiency. Intestinal rSO2 is a good predictor of the severity of NEC，but not fecal calprotectin.

    坏死性小肠结肠炎早产儿极低出生体重儿近红外局部组织氧饱和度钙卫蛋白

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    六岁以下儿童嗜酸细胞性胃肠炎临床特征分析

    李婧周锦赵艳吴捷...
    41-46页
    查看更多>>摘要：目的 分析6岁以下儿童嗜酸细胞性胃肠炎（EG）的临床特征，提高临床医生对该病的认识。 方法 收集2016年1月1日至2022年12月31日于首都医科大学附属北京儿童医院消化科住院治疗的6岁以下EG患儿的临床资料、实验室检查、影像学检查、消化道内镜及病理组织学检查结果、治疗及预后资料，总结6岁以下儿童EG的临床特点。 结果 共纳入31例6岁以下EG患儿，≤3岁14例，>3岁17例，38.71%（12/31）有多部位受累。腹痛（20/31，64.52%）为最常见的临床表现，其次为呕吐（11/31，35.48%）、便血（7/31，22.58%）、腹泻（7/31，22.58%）。单部位受累患儿症状分析显示，嗜酸细胞性十二指肠炎和嗜酸细胞性结肠炎患儿更易出现腹痛，发生率均为83.33%（10/12）（P<0.05）。70.97%（22/31）嗜酸性粒细胞增高，更常见于>3岁患儿（88.24%比50.00%，P<0.05）；29.03%（9/31）存在贫血，≤3岁患儿贫血发生率更高（50.00%比11.76%，P<0.05）；22.58%（7/31）存在低白蛋白血症；73.33%（22/30）食物过敏原特异性IgE（sIgE）阳性，牛奶、鸡蛋、小麦为最常见的过敏原。消化道内镜下可表现为黏膜充血水肿（29/31，93.55%）、黏膜红斑（26/31，83.87%）、粗糙（12/31，38.71%）、溃疡（10/31，32.26%）等。患儿均采取回避饮食治疗，在此基础上10例口服奥美拉唑，16例口服孟鲁司特，17例接受糖皮质激素治疗。治疗后整体复发或糖皮质激素依赖发生率32.26%（10/31），70.00%（7/10）于治疗1年内出现。 结论 6岁以下儿童EG可表现为单部位或多部位受累。腹痛为最常见的临床表现。患儿可能出现外周血嗜酸性粒细胞升高、贫血、低白蛋白血症。多数患儿存在食物过敏原。近1/3患儿会出现复发或糖皮质激素依赖。 Objective To analyze the clinical characteristics of eosinophilic gastroenteritis in children under 6 years old. Methods The clinical data，laboratory examinations，imaging examinations，gastrointestinal endoscopy，histopathology，treatment，and prognosis of patients under 6 years old with eosinophilic gastroenteritis who were hospitalized in the Department of Gastroenterology，Beijing Children's Hospital from January 1，2016 to December 31，2022 were collected and analyzed. Results A total of 31 children under 6 years of age with eosinophilic gastroenteritis were enrolled in the study,including 14 cases≤3 years old and 17 cases>3 years old, and 38.71% (12/31) of them had multiple sites involved. The main clinical manifestations were abdominal pain（20/31，64.52%），vomiting（11/31，35.48%），hematochezia（7/31，22.58%），and diarrhea（7/31，22.58%）.The children with eosinophilic duodenitis and eosinophilic colitis were more likely to have abdominal pain, with an incidence of 83.33%(10/12)（P<0.05）. Eosinophilia increased in 70.97%（22/31）of children，which was more common in children >3 years of age（88.24% vs. 50.00%，P<0.05）.Anemia was seen in 29.03%（9/31）of the patients，and it was more common in children under 3 years of age（50.00% vs. 11.76%，P<0.05）.Hypoalbuminemia was found in 22.58%（7/31）of patients. Specific IgE（sIgE）was positive in 73.33%（22/30）of children. Milk，egg，and wheat were the most common allergens. Gastrointestinal endoscopy showed mucosal edema（29/31，93.55%），erythema（26/31，83.87%），roughness（12/31，38.71%），ulcer（10/31，32.26%），et al.All children were treated with the elimination diet. Besides,10 cases were treated with omeprazole, 16 cases were treated with montelukast, and 17 cases were treated with glucocorticoid. The incidence of relapse or steroid resistance was 32.26%（10/31），and 70.00%（7/10）of them occurred within one year of treatment. Conclusion Eosinophilic gastroenteritis in children under 6 years of age may involve single or multiple sites.Abdominal pain is the most common clinical manifestation. Children may have elevated peripheral blood eosinophils，anemia，or hypoalbuminemia.Most children have food allergens. Nearly one-third of children experience relapse or steroid resistance.

    儿童,学龄前婴儿嗜酸细胞性胃肠道疾病临床特征

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    儿童淹溺53例临床特征及预后分析

    彭迎港谢乐云余阗王涛...
    47-51页
    查看更多>>摘要：目的 总结淹溺患儿临床特征及急救措施，为儿童淹溺的救治及预防提供科学依据。 方法 回顾性总结2011年1月至2021年12月湖南师范大学附属第一医院（湖南省人民医院）儿童医学中心收治的淹溺儿童临床资料。根据时间跨度分为两个阶段，第一阶段（2011至2016年）和第二阶段（2017至2021年），根据格拉斯哥-匹兹堡脑功能表现分级评估量表评估神经学预后，将心跳骤停患儿分为神经功能预后良好组和预后不良组。对不同时间段、不同预后的溺水患儿的基线特征、院前急救及预后等进行分析。 结果 研究期间共纳入53例患儿，第一阶段（2011至2016年）24例，第二阶段（2017至2021年）29例。其中男孩占73.6%（39/53），年龄范围为1个月24 d～14岁，其中1～4岁最为常见，占58.5%（31/53），发生淹溺季节以夏季多见（39.6%，21/53）。11.3%患儿有明显神经系统后遗症，病死率为3.8%（2/53）。同第一阶段相比，第二阶段淹溺控水的比例有所下降（37.5% 比 13.79%，P=0.046）。32例（60.4%）患儿淹溺后经历现场心肺复苏，其中神经学预后良好组24例，神经学预后不良组8例。预后不良组患儿需要心肺复苏持续时间长[10.00（1.50，25.00）min]，入院时体温、格拉斯哥昏迷评分、pH值较低，血糖水平较高（P均＜0.05）。 结论 淹溺多见于学龄前儿童，男孩常见，针对幼童的防淹溺措施理应重点关注。在淹溺时发现心脏骤停的患儿，其淹溺时间及心肺复苏持续时间长，预示着神经学预后不良，及时有效的现场心肺复苏是降低溺亡率的关键。 Objective To summarize the clinical characteristics and first aid measures of children with drowning，and to provide scientific basis for the treatment and prevention of drowning in children. Methods The clinical data of drowning children admitted to the Children's Medical Center of the First Affiliated Hospital of Hunan Normal University（Hunan Provincial People's Hospital）from January 2011 to December 2021 were retrospectively summarized. Baseline characteristics，prehospital emergency care and prognosis of the included children were analyzed.According to the time span, drowning children were divided into two stages, the first stage (2011-2016) and the second stage (2017-2021). According to cerebral performance category assessment scale,drowning children with cardiac arrest were divided into two groups: a group with good neurological prognosis and a group with poor neurological prognosis. The baseline characteristics,pre-hospital emergency care, and prognosis of drowning children during different periods and with different prognosis were analyzed. Results A total of 53 children were enrolled during the study period，with 24 cases in the first phase（2011-2016）and 29 cases in the second phase（2017-2021）.Boys accounted for 73.6%（39/53）of the cases, the age ranged from 1 month and 24 days to 14 years old，with 1-4 years old being the most common，accounting for 58.5%（31/53）, and the season in which drowning occurred was more common in the summer（39.6%, 21/53）.Six cases (11.3%) had significant neurological sequelae, and the mortality rate was 3.8%（2/53）.There was a decrease in the proportion of drowning with water control in the second stage compared to the first stage（37.5% vs. 13.79%,P=0.046）.Thirty-two（60.4%）children experienced on-site cardiopulmonary resuscitation(CPR) after drowning，with 24 cases in the group with good neurological prognosis and 8 cases in the group with poor neurological prognosis.Children in the poor neurological prognosis group required CPR for a long duration [10.00（1.50, 25.00）min]，had lower body temperature，Glasgow Coma Score，pH and higher blood glucose levels on admission（all P < 0.05）. Conclusion Drowning is most common in preschool children，common in boys，and drowning prevention measures for young children deserve focused attention. Children found to be in cardiac arrest at the time of drowning have a long duration of drowning and CPR，which predicts a poor neurological prognosis，and timely and effective on-site CPR is the key to reducing the drowning rate.

    儿童淹溺意外伤害心肺复苏临床特征

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