医院管理在基层医院新生儿窒息复苏推广中的作用  

Effect of Hospital Management on Popularization and Application of Neonatal Asphyxia Resuscitation in Community Hospitals

作　　者：吴时光 高平明[2] 梁颖[3] 麦智广[4] 张水堂[5] 蒙来成 彭晓霞 

机构地区：[1]佛山市南海区黄岐医院儿科,广东佛山528248 [2]佛山市妇幼保健院新生儿科,广东佛山528000 [3]佛山市妇幼保健院保健部,广东佛山528000 [4]佛山市第一人民医院儿科,广东佛山528000 [5]佛山市南海区妇幼保健院新生儿科,广东佛山528100 [6]佛山市顺德区人民医院儿科,广东佛山528200 [7]佛山市高明区妇幼保健院儿科,广东佛山528400

出　　处：《实用儿科临床杂志》2009年第6期434-436,457,共4页Journal of Applied Clinical Pediatrics

基　　金：佛山市医学类科技攻关项目资助(200708114)

摘　　要：目的通过对佛山市镇级医院的调研,探讨医院管理在基层医院新生儿窒息复苏推广中的作用。方法组织具有高级职称的新生儿科专家、产科专家和市、区妇幼保健行政管理人员,深入佛山市设立产科的所有镇级基层医院,采取科室现场考查、召开座谈会、无记名问卷调查、窒息复苏技术考核、查阅资料和病历等方式进行调研。依据《新生儿窒息复苏指南(2007北京修订)》制定《医院新生儿复苏管理综合评分表》,比较得分≥60分医院与<60分医院新生儿窒息复苏推广应用现状。结果医院管理综合评分最高为93.5分,最低42.5分,平均60.5分。≥60分医院19家(41.3%),<60分医院27家(58.7%)。佛山市89.1%镇级医院未成立医院窒息复苏领导小组或未正常开展工作。建立围生人员窒息复苏培训和窒息复苏技能考核制度的医院6家(13.04%),曾开展窒息复苏培训的医院10家(21.74%)。佛山市镇级医院新生儿窒息发生率为2.41%,≥60分医院新生儿窒息发生率和病死率低于<60分医院,差异具有显著意义(P<0.005,0.01)。复苏器具基本齐备的医院有39家(84.8%),但41家(89.3%)缺少胎粪吸管;复苏器具不齐备的均为<60分医院。≥60分医院窒息复苏方法正确率为68.4%,<60分医院窒息复苏方法正确率为48.6%;≥60分医院复苏用药合理占84.2%,<60分医院复苏用药合理占63.6%,差异具有非常显著意义(P<0.005)。结论医院管理是基层医院推广应用新生儿窒息复苏技术的主要环节和重要保障,卫生行政部门应尽快将新生儿窒息复苏管理纳入医院质量管理的考核指标。Objective To explore the role of hospital management on popularization and application in neonatal asphyxia resuscitation by investigation in community hospitals of Foshan city. Methods The investigation was carried out by a team of senior specialists in neonatology, obstetrics and administration in women and children health care. All the hospitals with obstetric department in Foshan city were involved in the investigation, and the methods included ward assessments, meeting with staffs, questionnaires, examination of resuscitation technique and reviewing of archives, et al. The scoring system of hospital management strategies for neonatal asphyxia resuscitation were established according to New Guideline for Neonatal Asphyxia Resuscitation 2007. A comparison of the current status of neonatal asphyxia resuscitation was made between the hospitals with scoring t〉 60 and those in 〈 60. Results The average score of hospital management strategies was 60.5 （ ranging from 42.5 to 93.5 ）. Nineteen hospitals （41.3%） were classified into scoring ≥ 60, and 27 hospitals （58.7 % ） into scoring 〈 60. In Foshan city, a neonatal resuscitation team was not established or not working in 89.1% of community hospitals, with only 6 hospitals （ 13.04% ） having routine resuscitation training and the assessment system for perinatal staffs. Resuscitation training had been carried out in 10 hospitals （21.74%）. The incidence of neonatal asphyxia was 2.41% in community hospitals of Foshan city, with incidence of morbidity or mortality in hospitals scoring t〉60 being significant lower than that in hospitals scoring 〈 60 （P 〈 0. 005,0.01 ）. Thirty - nine hospitals （84.8%） were well equipped for neonatal resuscitation, but 41 hospitals （89.3%） were not having special sucking tube for meeonium. Hospitals those were not well equipped were all located in the hospitals scoring 〈60. Resuscitation was 68.4% correctly carried out in the hospitals scoring≥60, but only 48.6% in the hospitals scoring 〈60

关 键 词：婴儿 新生 窒息复苏 医院管理 基层医院 推广应用 

分 类 号：R722.1[医药卫生—儿科]