早产儿监护病房八个月实践效果

Experiences of premature infants ICU: practices in 8 months

目的 探索适合国情的、能改善早产儿管理结果的组织形式。 方法 2003 年 3 月 1日至10月31日早产儿监护病房(premature infants ICU,PIICU)所有住院的早产低出生体重儿 316例为PIICU组,2002年3月1日至10月31日入NICU的所有早产儿243例为NICU组,对比分析所有患儿临床资料。 结果 两组间主要特殊治疗措施除中心静脉插管的使用率以 PIICU组较高(26.3%比14.4%,Z=-3.404,P<0.01)外,其他措施使用率差异均无显著性(P均>0.05);两组间除视网膜病变患病率(1. 3%比 1. 9%,Z= - 1. 063,P> 0. 05)差异无显著性外,总体出院痊愈率(94.0%比84.4%,Z=-3.710)、极低出生体重儿出院痊愈率(90.0 %比 73.6%,Z=-3.374)均为PIICU组高于NICU组(P均<0.01)。随访慢性肺部疾病(0.6%比2.9%,Z=-2.091)、脑发育不全的患病率(2.2%比6.2%,Z=-2.383)及住院期间并发症患病率均为PIICU组低于NICU组(P均<0.05)。 结论 PIICU的开展达到了改善救治效果的目的,且起积极作用的因素主要在于PIICU组织运行的本身。

Objective To explore the organization and management of premature infants which can improve the outcomes in our country. Methods The data of 316 premature infants in PIICU during March 1st to December 31st in 2003 were compared with 243 premature infants in NICU during the same months in 2002. Results Special treatments of the 2 groups had no significant difference (P>0.05) except for the PIICU group with more peripherally inserted central catheter (PICC)((26.3%) vs 14.4%,Z=-3.404,P<0.01).There was no difference in morbidity of retinopathy of premature (ROP) in these 2 groups(1.3% vs 1.9%,Z=-1.063,P>0.05). The NICU group has a higher rate of subsequent complication including chronic lung disease(0.6% vs 2.9%,Z=-2.091,(P<)0.05) and cerebral dysplasia(2.2% vs 6.2%,Z=-2.383,P<0.05).The PIICU group has a higher overall rate of recovery (94.0% vs 84.4%,Z=-3.710,P<0.01) and also a higher rate of recovery of extremely low birth weight infant(90.0 % vs 73.6%,Z=-3.374,P<0.01) than that of the NICU group. Conclusion The organization and management of PIICU can improve the outcomes of premature infants effectively.