区域性危重新生儿院前转运网络的意义与实践

Meaning and practice for net-work of pre-hospital transport about regional critically ill newborn

目的讨论危重新生儿院前转运网络的意义。方法建立以我院新生儿监护中心（NICU）为网络中心,以郴州市及周边地区共41家基层医院为成员单位的区域性危重新生儿院前转运网络系统,对危重新生儿进行转运,对转运新生儿例数、病种分布、愈后等临床资料进行分析。结果3年来转运1003例新生儿,转运新生儿逐年增加（P〈0.05）,转运后放弃63例,死亡70例,死亡率逐年降低（P〈0.05）。300例转运新生儿进行了转运前新生儿危重病例评分,其中非危重组68例,无死亡;危重组182例,死亡10例,死亡率5.49%;极危重组50例,死亡8例,死亡率16%。评分病情越重,病死率越高,差异有统计学意义（P〈0.05）。结论建立完善的院前转运网络系统,掌握转运指征和及时转运,对保证危重新生儿转运救治成功率,提高其日后的生存质量优化本地区人口结构有着十分重要的意义。

Objective To discuss the net-work significance of pre-hospital transport of Critically ill newborn. Methods With establishment of the net-work system of the pre-hospital transport of the part Critically ill newborn including NICU of our hospital, the emergent center, and the other hospitals of the Chenzhou city and its near hospitals, altogether 41 hospitals, we have evaluated the disease distribution and its number and prognostic of the transport newborn. Results The number of transport newbom is up every year in the 1 003 transport newborns of the near three years, abandoning 63 cases and 70 cases death among them, the rate of death is down every year（ P 〈 0.05）. we have had critical illness score before transport for 300 cases among them. There are 68 non-critically cases, no death case and 182 critically cases, including 10 death cases （the rate of death is 5.49% ） and 50 very critically cases including 8 death cases （the rate of death is 16%）. There were significant between death cases of the newborns （ P 〈 0. 05）. Conclusion To establish the advanced net-work system of the pre-hospital transport and control the stander and sure the transport of Critically ill newborn in time has very remarkable meanings about treatment rate and improvement life quality of the critically ill newborn and optimizing the area population structure.