主动院际转运对新生儿急性呼吸窘迫综合征治疗结局的影响  

Effects of active inter-hospital transfer on the clinical outcomes of neonatal acute respiratory distress syndrome

作　　者：王劲 王丹[1] 李婷婷 曾凌空[1] 王石 Wang Jin;Wang Dan;Li Tingting;Zeng Lingkong;Wang Shi(Department of Neonatology,Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)新生儿内科,武汉430000

出　　处：《中华新生儿科杂志（中英文）》2023年第10期593-597,共5页Chinese Journal of Neonatology

基　　金：湖北儿科联盟医学科研项目(HBPAMR-2021-06)。

摘　　要：目的:探讨主动院际转运对新生儿急性呼吸窘迫综合征(neonate acute respiratory distress syndrome,nARDS)治疗结局的影响。方法:回顾性分析2018年9月至2020年12月经陆路转运至华中科技大学同济医学院附属武汉儿童医院新生儿重症监护病房的nARDS患儿资料,比较主动转运组和被动转运组患儿疾病情况、nARDS严重程度分布、并发症发生率、氧疗时间、机械通气时间及住院时间的差异。结果:共纳入78例患儿,主动转运组45例,被动转运组33例。两组胎龄、出生体重、nARDS严重程度、转运距离及转运时长差异无统计学意义(P>0.05)。主动转运组气胸发生率低于被动转运组[6.7%(3/45)比18.2%(6/33)],差异有统计学意义(P<0.05);两组肺出血、新生儿持续肺动脉高压、脑室内出血、缺氧缺血性脑病发生率及住院时间差异无统计学意义(P>0.05)。主动转运组氧疗、无创呼吸机和有创呼吸机通气时间均短于被动转运组[(9.7±2.9)d比(11.3±4.0)d、(2.7±1.0)d比(3.7±1.4)d、(5.0±1.9)d比(6.2±2.3)d],差异有统计学意义(P<0.05)。结论:主动院际转运可减少nARDS患儿气胸的发生,缩短住院期间氧疗时间、无创呼吸机和有创呼吸机通气时间。Objective To study the effects of active inter-hospital transfer on the clinical outcomes of neonatal acute respiratory distress syndrome(nARDS).Methods From September 2018 to December 2020,neonates with nARDS transferred by ground ambulance to NICU of our hospital were retrospectively analyzed.The neonates were assigned into active transfer group and passive transfer group.Their general status,severity of nARDS,incidences of complications,duration of oxygen therapy,mechanical ventilation and hospital stay were analyzed.Results A total of 78 neonates were enrolled in the study,including 45 cases in active transfer group and 33 cases in passive transfer group.No significant differences existed in gestational age,body weight,severity of nARDS,transfer distance and transfer duration between the two groups(P>0.05).Active transfer group had significantly lower incidence of pneumothorax(3/45,6.7%)than passive transfer group(6/33,18.2%)(P<0.05).No significant differences existed in the incidences of pulmonary hemorrhage,persistent pulmonary hypertension of newborn,intraventricular hemorrhage,hypoxic ischemic encephalopathy and length of hospital stay between the two groups(P>0.05).Active transfer group had significantly shorter duration of oxygen therapy[(9.7±2.9)d vs.(11.3±4.0)d],non-invasive[(2.7±1.0)d vs.(3.7±1.4)d]and invasive ventilation[(5.0±1.9)d vs.(6.2±2.3)d]than passive transfer group(P<0.05).Conclusions Active inter-hospital transfer may reduce the incidence of pneumothorax in neonates with nARDS,shorten the duration of oxygen therapy,non-invasive and invasive ventilation during hospitalization without affecting the length of hospital stay.

关 键 词：院际转运 主动 新生儿急性呼吸窘迫综合征 

分 类 号：R722.1[医药卫生—儿科]