河南省市县级危重新生儿救治中心建设及救治情况的多中心调查  

A multicenter survey of critical neonatal care centers construction and treatment of critically-ill neonates at city-and county-level in Henan Province

作　　者：马徜徉 张晨[1] 李文丽[1] 夏磊[1] 薛倩茹 张萌[1] 秦璠玥 徐发林[1] Ma Changyang;Zhang Chen;Li Wenli;Xia Lei;Xue QianRu;Zhang Meng;Qin Fanyue;Xu Falin(Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院新生儿科,郑州1450052

出　　处：《中华新生儿科杂志（中英文）》2023年第7期419-423,共5页Chinese Journal of Neonatology

摘　　要：目的调查河南省市县级危重新生儿救治中心建设现状及2019—2021年危重症新生儿救治情况,为加强和优化危重新生儿救治中心建设提供依据。方法于2022年1月向河南省市、县级危重新生儿救治中心进行问卷调查,根据收回的问卷分析各级别新生儿救治中心的基本情况、病区设置、产科新生儿管理模式以及2019—2021年危重症新生儿救治情况。结果共发放问卷188份,收回合格问卷183份(97.3%),其中市级中心30份,县级中心153份。县级中心床位使用率明显低于市级中心(67.3%±24.1%比86.1%±23.2%),医生床位比、医生数/抢救床位数、护士数/抢救床位数高于市级中心,差异均有统计学意义(P<0.05)。市级救治中心新生儿病区均独立设置,县级救治中心独立设置比例为92.8%(142/153)。产科新生儿80.9%(148/183)由产科管理,儿科参与会诊转诊;19.1%(35/183)由儿科/新生儿科管理。3年间市、县级中心产科平均分娩量及新生儿科平均住院人数均逐年下降,但其救治早产儿、低/极低出生体重儿占比逐年上升。各中心新生儿院内死亡率呈下降趋势,市级中心院内死亡率明显高于县级中心。3年来市级中心收治的前3位病种为新生儿呼吸窘迫综合征、新生儿窒息、急性呼吸窘迫综合征,县级中心收治的前3位病种为新生儿窒息、新生儿呼吸窘迫综合征、胎粪吸入综合征。市、县级中心收治新生儿中突发衰竭/猝死比例为(10~30)/10万。结论河南省危重新生儿救治中心建设面临着住院人数下降、危重症新生儿比例上升等挑战,存在产儿科合作不足、资源浪费等问题,需合理配置、优化资源利用,不断提高危重症新生儿救治能力。Objective To study the current status of critical neonatal care centers(CNCC)construction and treatment of critically-ill neonates at city-and county-level in Henan Province.Methods A questionnaire survey was conducted in January 2022 to city-and county-level CNCC in Henan Province.The basic information of CNCC,ward settings,neonatal management in the Department of Obstetrics and the treatment of critically-ill neonates in 2019-2021 were analyzed.Results A total of 188 questionnaires were sent and 183(97.3%)eligible questionnaires were analyzed,including 30 from city centers and 153 from county centers.The bed occupancy rate in county centers was significantly lower than city centers(67.3%±24.1%vs.86.1%±23.2%),and the doctor/bed ratio,doctor/rescue bed ratio and nurse/rescue bed ratio were significantly higher than city centers(P<0.05).All city centers had set up independent Department of Neonatology and the number is 92.8%(142/153)in county center.For 80.9%(148/183)centers,neonates were managed in the Department of Obstetrics with consultations and referrals to the Department of Pediatrics and 19.1%(35/183)were managed in the Department of Pediatrics/Neonatology.The average number of deliveries and admissions to the Department of Neonatology in both city and county centers decreased year on year during 2019-2021,but the proportion of premature and low/very low birth weight infants treated in these centers increased year on year.During 2019-2021,the top three diseases treated at the city centers were neonatal respiratory distress syndrome,neonatal asphyxia and acute respiratory distress syndrome,while the top three diseases treated at the county centers were neonatal asphyxia,neonatal respiratory distress syndrome and meconium aspiration syndrome.The incidence of sudden infant death syndrome in city and county centers was(10~30)/100,000.Conclusions The construction of CNCC in Henan Province is facing challenges such as decreased hospital admissions,increased critically-ill neonates,insufficient cooperation betw

关 键 词：危重新生儿救治中心 建设现况 急救医疗服务 

分 类 号：R722.1[医药卫生—儿科]