急危重先天性心脏病新生儿237例院际转运的临床研究  

Clinical study of inter-hospital transport of 237 neonates with acute and critical congenital heart disease

作　　者：吴家兴 刘玉梅[1] 孙云霞[1] 钟劲[1] 余宇晖[1] 郑曼利[1] 王一飞[1] 邹有群[1] 孙新[1] 陈亮[1] 陈寄梅 何少茹[1] Wu Jiaxing;Liu Yumei;Sun Yunxia;Zhong Jin;Yu Yuhui;Zheng Manli;Wang Yifei;Zou Youqun;Sun Xin;Chen Liang;Chen Jimei;He Shaoru(Department of Pediatrics,Guangdong Provincial People′s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China;Department of Cardiac Surgery,Guangdong Provincial People′s Hospital,Guangdong Academy of Medical Sciences,Guangdong Provincial Cardiovascular Institute,Guangdong Provincial Key Laboratory of South China Structural Heart Disease,Guangzhou 510100,China)

机构地区：[1]广东省人民医院/广东省医学科学院儿科,广州510080 [2]广东省人民医院/广东省医学科学院心外科,广东省心血管病研究所,广东省华南结构性心脏病重点实验室,广州510100

出　　处：《中华实用儿科临床杂志》2020年第18期1384-1387,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家重点研发计划(2018YFC1002600)。

摘　　要：目的探讨院际急危重先天性心脏病新生儿转运过程中的安全性及其预后。方法回顾性分析2016年7月至2018年7月广东省人民医院新生儿科转运团队主动院际转运237例急危重先天性心脏病新生儿转院前的危重评分、转运路程和需要的时间以及转运途中、住院期间相关资料和患儿的转归。结果237例患儿中,男162例,女75例;转运的中位日龄为6 d,中位体质量2.98 kg;转运前新生儿危重病例评分(NCIS)(86.54±9.05)分,>90分136例,70~90分84例,<70分17例;转运距离中位数90 km,转运到新生儿重症监护室(NICU)时NCIS(87.05±8.19)分,>90分138例,70~90分82例,<70分17例,根据转运时间和路程分组,转运前后危重病例评分差异无统计学意义(t=0.346,P>0.05);转运前后各急危重症患儿生命体征无明显恶化;转运过程中无一例死亡,外科手术及内科介入治疗好转及治愈出院222例,放弃治疗或丧失手术时机后死亡15例。结论院际急危重先天性心脏病新生儿转运按照原则及转运规章制度,做好双方医院医护人员的沟通,转运设备齐全,转运途中认真观察及作出正确的评估和处理,急危重先天性心脏病新生儿的转运是安全有效的。Objective To investigate the safety of inter-hospital referral and the prognosis of neonatal with critical congenital heart disease.Methods The criticality score, transit distance and time, and the prognosis of 237 newborns with critical congenital heart disease in Guangdong Provincial People′s Hospital from July 2016 to July 2018 were retrospectively analyzed.Results A total of 237 children were included (162 male and 75 female) with the median age of 6 days and the median body weight of 2.98 kg.The median transit distance was 90 km.The average value of neonatal critical illness score (NCIS) was (86.54±9.05) scores before transport;136 cases were greater than 90 scores, 84 cases between 70 and 90 scores, 17 cases less than 70 scores;while the average NCIS was (87.05±8.19) scores when arrived at neonatal intensive care unit (NICU), 138 cases were greater than 90 scores, 82 cases between 70 and 90 scores, 17 cases less than 70 scores.There were no significant differences in the scores of critical cases before and after transfer according to the transfer time and distance (t=0.346, P>0.05). There was no one death occurred during the transfer process.All over, 222 cases were cured and discharged from the hospital after surgery and or medical interventional treatments, 15 cases died after giving up treatment or losing the opportunity for surgery.Conclusions It is safe and effective of the inter-hospital transport for the rescue of infants with critical congenital heart disease when followed the principles and transport rules and regulations, with trained workers and special equipments.

关 键 词：急危重症 先天性心脏病 婴儿 新生 院际转运 

分 类 号：R722.1[医药卫生—儿科]