不同转运方式新生儿临床及转归对比分析

Comparative analysis of clinical characteristics and outcome of neonates transferred by different

目的探讨不同转运方式新生儿临床及转归情况。方法对2009年7月至2010年7月转至青岛大学医学院新生儿重症监护室（neonatal intensive care unit，NICU）1027例新生儿行前瞻性分析。按转运方式不同分双程转运、求助医院单程转运和家属单程转运。比较三组患儿入院情况、院前急救措施和出院情况等。计量资料行X^2检验、计数资料行方差分析、转归情况行Mann Whitney U检验统计学处理。结果双程转运、求助医院单程转运和家属单程转运患儿人院年龄中位数是0．46d，0．33d，5d；双程转运和求助医院单程转运的患儿胎龄、出生体质量小于家属单程转运，然而病情危重程度重于家属单程转运，并且住院花费高于家属单程转运，差异具有统计学意义（P〈0．05）；除保暖措施，余急救措施各组差异均有统计学意义（X^2=96．855—103．863，P〈0．05）；家属单程转运治愈好转出院百分率最高，各组转归情况差异具有统计学意义（Z=-1．987～-5．347，P〈0．05）。结论双程转运和求助医院单程转运新生儿的入院年龄小、出生体质量低、胎龄小、病情重，住院花费高且治愈好转出院百分率低。

Objective To explore the clinical characteristics and outcome of neonates transferred by different ways. Method A total of 1 027 neonates transferred to neonatal intensive care unit （NICU） of our hospital from July 2009 to July 2010 were analyzed prospectively. They were divided into three groups： twoway transport（TWT）, hospital-aided one-way transport（HAT） and self-help one-way transport（SHT）. The conditions at admission and discharge and pre-hospital care of the neonates were compared between the groups. The data were statistically analyzed with square tests, variance analysis and Mann Whitney U test. Results The median ages of TWT, HAT, and SHT groups at admission were 0.46 d, 0.33 d and 5 d respectively. The TWT and HAT neonates had smaller gestational age and birth weight than SHT ones, had more severe conditions and cost more, and the differences were significant （ P 〈 0.05 ）. Significant differ- ences existed in all emergency treatment except in warming measures（ X2 =96. 855 -103. 863, P 〈 0.05）. The cure percentage at discharge was the highest in SHT group, and differences in treatment results of three groups were significant （Z = - 1. 987 to - 5. 347, P 〈 0.05 ）. Conclusions The TWT and HAT neonates have smaller gestational age, ages at admission and birth weight than SHT ones, have more severe condi- tions, cost more and lower cure percentage at discharge than SHT ones.