95家危重新生儿救治中心建设现状调查  

Investigate of the status of 95 critical newborn treatment centers

作　　者：彭健茹 韩涛[2] 李秋平 杨常栓 张艳平 张珊[2] 李磊[2] 王自珍 朱柠 孔祥永 Peng Jianru;Han Tao;Li Qiuping;Yang Changshuan;Zhang Yanping;Zhang Shan;Li Lei;Wang Zizhen;Zhu Ning;Kong Xiangyong(Department of Neonatology,Huizhou Central People’s Hospital,Guangdong,Huizhou 516000,China;Neonatal Intensive Care Unit,Faculty of Pediatrics,the Seventh Medical Center of PLA General Hospital,Beijing 100700,China;The Second Clinical School of Medicine,Southern Medical University,Guangdong,Guangzhou 510000,China)

机构地区：[1]惠州市中心人民医院新生儿科,广东惠州516000 [2]解放军总医院儿科医学部解放军总医院第七医学中心新生儿重症监护病房,北京100700 [3]南方医科大学第二临床医学院,广东广州510000

出　　处：《发育医学电子杂志》2024年第2期102-107,共6页Journal of Developmental Medicine (Electronic Version)

基　　金：国家卫生健康委员会妇幼健康司资助项目(2020-2021)。

摘　　要：目的评估《危重新生儿救治中心建设与管理指南》(以下简称《指南》)在指导危重新生儿救治中心(以下简称“救治中心”)资源建设上的有效性、针对性和可操作性。方法2019年6月至12月,在我国东、中、西部地区共选取95家救治中心,其中省级25家,市级35家,县级35家,对危重新生儿救治网络建设现状进行调查。调查内容包括病房建设、设备配置和开展的技术项目。统计学方法采用χ^(2)检验或Fisher确切概率法。结果25家省级救治中心均在三级甲等医院,57%(20/35)的市级救治中心在三级甲等医院。省、市、县级救治中心床位数达标率分别为64%(16/25)、71%(25/35)、89%(31/35)。95家救治中心均能开展新生儿复苏和蓝光治疗。25家省级救治中心均能开展普通氧疗、气管插管、无创监测、血气分析、持续气道正压通气(continuous positive airway pressure,CPAP),但亚低温治疗、腹膜透析、连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)等技术项目的达标率较低。部分市级救治中心未按《指南》要求开展CPAP、高频通气、换血疗法和经外周置入中心静脉导管(peripherally inserted central catheter,PICC)。部分县级救治中心的基本技术尚未达标,如气管插管、无创监测、普通氧疗等。省、市、县3级比较,新生儿复苏、气管插管、CPAP、蓝光治疗、血气分析等技术项目的达标率差异无统计学意义(P>0.05);而换血疗法、无创监测、普通氧疗、PICC等技术项目比较,差异有统计学意义(P<0.05),省级达标率较高。结论部分救治中心的床位设置、设备配置、技术项目需要进一步完善,以推动新生儿救治中心及区域协作救治网络体系的建设。Objective To evaluate the effectiveness,pertinence and operability of the Guidelines for the Construction and Management of Critical Newborn Treatment Centers(hereinafter referred to as the"Guidelines")in guiding the resource construction of critical newborn treatment centers(hereinafter referred to as"treatment centers").Method From June to December 2019,a total of 95 treatment centers were selected in the eastern,central and western regions of China,including 25 at the provincial level,35 at the municipal level and 35 at the county level,to investigate the status of the treatment network construction for critically ill newborns.The contents of the survey included the construction of the ward,equipment configuration and technical items.Statistical methods wereχ^(2) test or Fisher exact probability method.Result 25 provincial-level treatment centers were in gradeⅢA hospitals,and 57%(20/35)of municipal treatment centers were in gradeⅢA hospitals.The rates of the number of beds in provincial,municipal and countylevel treatment centers reaching the standard were 64%(16/25),71%(25/35)and 89%(31/35),respectively.All 95 treatment centers performed neonatal resuscitation and blue light therapy.The 25 provincial treatment centers carried out ordinary oxygen therapy,tracheal intubation,non-invasive monitoring,blood gas analysis,continuous positive airway pressure(CPAP).However,technical programs such as mild hypothermia therapy,peritoneal dialysis,and continuous renal replacement therapy(CRRT)had a low rate of meeting standards.Some municipal treatment centers did not implement CPAP,high-frequency ventilation,exchange transfusion,and peripherally inserted central catheter(PICC)as required by the Guidelines.The basic technologies of some county-level treatment centers had not reached the standard,such as tracheal intubation,noninvasive monitoring,and ordinary oxygen therapy.There was no significant difference in the meeting standards rate of neonatal resuscitation,tracheal intubation,CPAP,blue light therapy and blood

关 键 词：危重新生儿 救治中心 指南 现状调查 技术项目 

分 类 号：R722.1[医药卫生—儿科]