全国156所试点医院新生儿早期基本保健技术实施现状及效果评价  

Implementation status and effectiveness evaluation of early essential newborn care in 156 pilot hospitals

作　　者：杨小松 林昀 徐韬[1] Yang Xiaosong;Lin Yun;Xu Tao(Department of Child Health Care,Maternal and Child Health Care Center of Chinese Center for Disease Control and Prevention,Beijing 100081,China)

机构地区：[1]中国疾病预防控制中心妇幼保健中心儿童保健部,北京100081

出　　处：《中华围产医学杂志》2024年第7期582-587,共6页Chinese Journal of Perinatal Medicine

基　　金：国家卫生健康委员会-联合国儿童基金会新生儿安全项目(501MCH)。

摘　　要：目的了解我国新生儿早期基本保健(early essential newborn care,EENC)核心措施实施现状。方法基于国家卫生健康委员会-联合国儿童基金会“新生儿安全项目”,对161所试点医院的8项EENC核心措施,包括出生后立即开展至少90 min母婴皮肤接触、延迟脐带结扎(延迟至生后1 min或脐带停止搏动)、出生后1 h内完成首次母乳喂养、出院时纯母乳喂养、延迟第1次洗澡(出生24 h之后)、袋鼠式护理、眼部护理(使用红霉素药膏或其他滴眼液)和肌内注射维生素K1的实施情况进行问卷调研。调查表由试点医院根据2022年1月1日至12月31日实际情况填写,其中新生儿疾病信息来自该院新生儿出生至出院期间的病历记录,新生儿死亡率通过助产机构门诊和住院病历记录获得。主要分析指标为东、中、西地区EENC核心措施实施率,以及开展EENC医院和未开展EENC医院新生儿死亡率及新生儿常见病发生率。数据比较采用χ^(2)检验。结果共156所试点医院完成调查,其中东部地区66所(42.3%),中部地区45所(28.8%),西部地区45所(28.8%)。西部地区出生后立即开展至少90 min母婴皮肤接触、出生后1 h内完成首次母乳喂养、出院时纯母乳喂养、袋鼠式护理、眼部护理和肌内注射维生素K1的实施率均高于东、中部地区[分别为60.1%(62491/104012)与22.4%(104991/467982)和29.4%(31419/106812)、76.5%(78188/102266)与41.2%(188740/458627)和62.9%(67200/106812)、74.0%(60062/81141)与39.7%(181921/458627)和70.2%(74947/106812)、27.9%(1407/5035)与9.4%(1670/17807)和22.9%(2510/10968)、46.9%(48442/103313)与23.0%(105917/461176)和31.4%(31731/100966)、96.2%(51674/53729)与56.6%(263273/465433)和92.1%(98365/106812),χ^(2)值分别为58218.40、50113.04、55466.24、1456.92、24686.13、72696.66,P值均<0.001]。中部地区延迟脐带结扎、延迟第1次洗澡的实施率均高于东、西部地区[76.9%(82161/106812)与37.0%(163808/443285)和59.3%(60596/102266)�Objective To investigate the current implementation status of early essential newborn care(EENC)core interventions in China.Methods Based on the Safe Neonatal Project jointly launched by the National Health Commission and United Nations International Children's Emergency Fund(UNICEF),a questionnaire survey was conducted on the implementation of eight EENC core interventions in 161 pilot hospitals.The eight interventions were skin-to-skin contact immediately after birth for at least 90 min,delayed cord clamping(until 1 min after birth or after the cord stopped pulsating),initiation of breastfeeding within the first hour after birth,exclusive breastfeeding at discharge,delayed first bath(24 h after birth),kangaroo mother care,eye care(using erythromycin ointment or other eye drops),and intramuscular injection of vitamin K1.The survey was completed by the pilot units based on actual conditions from January 1 to December 31,2022.Neonatal disease information was obtained from medical records from birth to discharge,and neonatal mortality rates were obtained from outpatient and inpatient records in obstetric institutions.The main indicators were the implementation rates of EENC core interventions in the eastern,central,and western regions,as well as the neonatal mortality and the incidence of common neonatal diseases in hospitals that implemented EENC or not.Chi-square test was used for data comparison.Results A total of 156 pilot hospitals completed the survey,with 66(42.3%)in the eastern region,45(28.8%)in the central region,and 45(28.8%)in the western region.The implementation rates of skin-to-skin contact immediately after birth for at least 90 min,initiation of breastfeeding within the first hour after birth,exclusive breastfeeding at discharge,kangaroo mother care,eye care,and intramuscular injection of vitamin K1 were higher in the western region than in the eastern and central regions[60.1%(62491/104012)vs.22.4%(104991/467982)and 29.4%(31419/106812),76.5%(78188/102266)vs.41.2%(188740/458627)and 62.9%(67200/1068

关 键 词：新生儿死亡率 试点医院 肌内注射 纯母乳喂养 新生儿疾病 病历记录 眼部感染 实施现状 

分 类 号：R174[医药卫生—妇幼卫生保健]