宜宾市新生儿转运系统应用现状分析  

Analysis of current situations of neonatal emergency transport system in Yibin City

作　　者：古丽[1] 黄薇[1] 王模奎[1] 苏华英[1] 杨介梅[1] Gu Li;Huang Wei;Wang Mukui;Su Huaying;Yang Jiemei(Department of Neonatology,First People′s Hospital of Yibin,Yibin 644000,Sichuan Province,China)

机构地区：[1]四川宜宾市第一人民医院新生儿科,四川644000

出　　处：《中华妇幼临床医学杂志（电子版）》2018年第1期85-91,共7页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：四川省教育厅重点基金项目(08ZA150);宜宾市科学技术局资助项目(2014SF002)~~

摘　　要：目的探讨四川省宜宾市新生儿急救转运系统(NETS)的应用现状。方法选择2015年1月至2016年12月,通过宜宾市第一人民医院NETS转运至本院新生儿科的1 184例危重新生儿为研究对象。根据这1 184例患儿采取NETS转运至新生儿科的时间,将其分别纳入2015年组(n=645)与2016年组(n=539)。采用回顾性分析方法,收集2组患儿的一般临床资料,疾病种类(按照入院第一诊断结果进行分类),转诊医院、转诊距离和时间,住院治疗情况,住院时间和费用,以及转归情况。采用成组t检验,对2组患儿的转诊距离、转诊时间进行比较。采用Wilcoxon秩和检验,对2组患儿给氧治疗时间、经鼻持续正压通气(nCPAP)时间、气管插管机械通气时间、住院时间及住院费用进行比较。采用χ~2检验,对2组患儿采取NETS转运时的日龄及转诊医院构成比、给氧治疗率、nCPAP治疗率、气管插管机械通气治疗率进行比较。本研究遵循的程序符合宜宾市第一人民医院伦理委员会制定的伦理学标准,得到该委员会批准,征得患儿监护人知情同意,并与其签署临床研究知情同意书。2组采取NETS转运患儿的性别、出生胎龄及出生体重构成比等一般临床资料比较,差异均无统计学意义(P>0.05)。结果 (1)2015年1月至2016年12月,采取NETS转运至本院新生儿科的危重新生儿共计1 184例,转运途中无1例死亡。(2)2016年组患儿采取NETS转运时的日龄≤24h者所占比例为81.1%(437/1 184),显著高于2015年组的71.2%(459/1 184),2组比较,差异有统计学意义(χ~2=15.676,P<0.001)。(3)采取NETS转运患儿的前3位疾病为:新生儿肺炎632例(53.4%,632/1 184);新生儿缺氧缺血性脑病122例(10.3%,122/1 184);新生儿高胆红素血症91例(7.7%,91/1 184)。(4)采取NETS转运的患儿来自54家医院,转诊距离为(45.8±28.4)km,转诊时间为(71.6±43.2)min。2015年组与2016年组患儿所在转诊医院级别构成比、不同级别医院转诊患To explore the current situations of neonatal emergency transport system(NETS)in Yibin,Sichuan Province.Methods A total of 1 184 neonates with critical illness transferred into Department of Neonatology,First People′s Hospital of Yibin by NETS from January 2015 to December 2016 were chosen as study subjects.They were divided into two groups according to the year transferred into Department of Neonatology by NETS:2015 year group(n=645)and 2016 year group(n=539),respectively.The general clinical data,composition of diseases(classified according to the result of first diagnosis at the time of admission),referral hospitals,referral distance and time,strateges of hospitalization treatment,duration of hospital stay,hospitalization expenses,and outcomes of all neonates were retrospectively analyzed.The referral distance and time of two groups were compared by independent samples t test.The durations of oxygen therapy,nasal continuous positive airway pressure(nCPAP)and tracheal cannula mechanical ventilation,duration of hospital stay,hospitalization expenses between two groups were compared by Wilcoxon rank sum test.The constituent ratios of day-age at the time of admission by NETS and referral hospitals,rates of oxygen therapy,nCPAP and tracheal cannula mechanical ventilation between two groups were compared by chi-square test.This study was approved by the Ethics Committee of Human Beings in First People′s Hospital of Yibin and guardians of every subject signed informed consent of clinical research.There were no statistical differences between two groups in constituent ratios of gender,gestational age and birth weight(P>0.05).Results①From January 2015 to December 2016,a total of 1 184 neonates with critical illness were transferred into our hospital by NETS,and none of them died during transfer process.②The ratio of neonates transferred into our hospital by NETS within 24 h after birth in 2016 year group was 81.1%(437/1 184),which was higher than that in 2015 year group 71.2%(459/1 184),and the difference was s

关 键 词：危重病 肺炎 新生儿 缺氧缺血性脑病 新生儿 高胆红素血症 新生儿 新生儿急救转运系统 区域性 婴儿 新生 

分 类 号：R720.597[医药卫生—急诊医学]