213例机械通气新生儿院间转运的管理

Management of 213 newborns required mechanical ventilation during transportation between hospitals

目的探讨机械通气新生儿院间转运的管理策略和效果。方法回顾分析广州市妇女儿童医疗中心，广州市儿童医院2006年1月至2007年12月对213例机械通气新生儿院间转运的常规管理方法，转运过程中出现的各种紧急情况与并发症以及相应处理措施和结局。结果213例机械通气新生儿均安全转运到目的地医院，转运成功率为100．0％。转运前有11例患儿使用镇静剂，157例留置胃管。转运过程中需停车进行应急处理3例，其中1例患儿发生气管插管脱管，1例心跳骤停，1例气管导管阻塞，经对症处理后均好转。转运后经过治疗痊愈195例（91．6％），放弃治疗11例（5．2％），死亡7例（3．3％）。结论机械通气新生儿病情危重，技术精湛的转运人员、充分的转运前准备和密切的转运中监测以及积极而正确的处理是保证机械通气新生儿院问转运成功的必备条件。

Objective To explore the strategies and results of transportation between hospitals for neonates under mechanical ventilation. Methods From January 2006 to December 2007, medical records of 213 newborn infants under mechanical ventilation transported to Guangzhou Women and Children＇s Medical Center, Guangzhou Children＇s Hospital from other hospitals were reviewed. Emergent events, complications and relative managements and prognosis during the transportation were analyzed. Results No patients died during the transportation, giving a rate of success of 100%. Before transportation, 11 babies received sedatives and 157 were transported with indwelling gastric tube. During transportation, three cases required temporary parking for some emergency, and relieved after proper management. One case was due to dislocation of the tracheal tube, one due to cardiac arrest and one due to the tracheal tube block. After transportation, 195 patients （91.6%） were fully recovered, 11 （5.2%） failed to receive any treatment, 7（3.3%） died. Conclusions Skilled doctors and nurses, full preparation before transportation and close monitoring and prompt and proper management during the transportation are essential for successful transportation of newborns under mechanical ventilation.