中国109家医院新生儿专业现状调查

Present situation of neonatal subspecialty in the mainland of China： a survey based on 109 hospitals

目的了解中国内地医院新生儿专业现状，为促进和规范我国新生儿学科发展提供参考依据。方法采取调查表形式对国内不同地区共109家医院新生儿专业现状进行调查并进行汇总分析。结果109家医院分布于22个省市，其中设置新生儿科的有68家，占总数的62．4％，归属儿科但单独成组的为41家，占37．6％。平均新生儿床位为35．95张（6-300张，中位数30），其中三甲医院平均为45．21张（9-300张，中位数35）。109家医院总体医护床位比分别为1：3．24和1：1．42。院均拥有新生儿抢救台4．50台，暖箱23．83台，常频呼吸机3．00台，CPAP2．55台。包括ECMO在内的22项救治技术均已开展，但仅新法复苏开展率为100％，其中有8项技术开展率尚不足50％。2008年109家医院共收治139084例，平均收治例数为1276例（32-5500例，中位数1160），总体抢救成功率为95．31％，总体住院新生儿病死率为1．43％，其中极低出生体重儿救治存活率为82．43％，超低出生体重儿救治存活率为41．30％。62家医院（56．90％）开展了新生儿转运工作，在54家提供了详细转运数据的医院中，2008年共转运新生儿17807例次，院年平均转运330例次（12-5130例，中位数147例），转运患儿占转运医院年总收治患儿的平均比例为20．28％。结论调查显示我国内地医院新生儿专业虽已具备相当规模，但发展水平参差不齐。应尽快建立适合我国国情的NICU分级管理和准入制度以及病房建设标准，进一步引导和规范新生儿专业发展。

Objective To investigate the present situation of neonatal subspecialty in the mainland of China, and provide reference data for further development and standardization of neonatal discipline in China. Methods Data of neonatal subspeciahy of 109 hospitals in the mainland of China acquired by questionnaire were collected and analyzed. Results Of the 109 hospitals that located in 22 provinces, municipalities and autonomous regions, 68 （62.4%）had independent neonatology departments, and 41 （37.6%） had neonatal subspecialty groups affiliated to pediatric departments. The average number of neonatal beds was 35.95 （ range from 6 to 300, median 30） per unit, compared with a number of 45.21 per unit in grade ]H-A general hospitals （range from 6 to 300,median 30）. In all the 109 hospitals,the general beds to physicians ratio and beds to nurses ratio were 1 ： 3.24 and 1 ： 1.42, respectively. Each unit was in average equipped with 4. 50 infant radiant warmers, 23.83 neonatal incubators, 3 normal frequency ventilators and 2. 55 CPAP ventilators. All 22 clinical technologies,including ECMO, had been carried out, but only the new resuscitation technique has been carried out in each of these hospitals, and there were stilleight technologies that were carried out in less than 50% hospitals. Totally 139 084 infants were treated in 109 hospitals in 2008, with the average number of 1276 patients per unit （range from 32 to 5500, median 1160）. The average survival rate and mortality rate during hospitalization were 95.31% and 1.43%, respectively, while the survival rate of very low birth weight premature infants and extremely low birth weight premature infants were 82.43% and 41.30% , respectively. Transport service was provided in 62（56. 9% ） hospitals, with the average transport number of 330 infants per hospital, accounting for 20. 28% of the total admission. Conclusion The survey shows that neonatal subspecialty in the mainland of China already has a considerable size,however, the development is not balanced. The system of classification of neonatal units and standards of ward construction suitable for China should be set up as soon as possible.