院间转运重症患儿流行病学特征分析

The epidemic characteristics of interhospital transport of critically ill pediatric patients

目的本研究对2009至2012年院问转诊重症患儿进行流行病学特征分析，探讨重症患儿院间转诊的必要性。方法2009年1月至2012年6月期间采用横断面研究的方法收集9231例院间转诊患儿的性别、年龄、季节和转运距离等流行病学资料。结果9231例院间转诊患儿男女比例为2．24：1，87．39％（8067／9231）的院间转诊患儿是新生儿和婴儿；66．32％（6122／9231）转诊患儿来自基层医院的儿科、新生儿科和妇产科，不同年份转诊患儿的转出科室存在差异，并有统计学意义（χ2=227．53，P〈0．0001）；56．88％（5251／9231）的转诊患儿转诊半径在150公里以上，仅有12．18％（1124／9231）的转诊患儿转运半径在50公里以内；52．89％（4882／9231）的院间转诊发生在冬春季节，不同年份转诊患儿季节分布存在差异，并有统计学意义（χ2=1201．88，P〈0．0001）；接转诊电话的时间主要集中在上午9时-12时。结论由于基层医院条件、设备和技术的限制，危重患儿有必要转诊到三级医院进行救治；根据危重患儿转诊的流行病学特征，转运中心应该采取应急措施达到及时安全有效的院间转运。

Objective The purpose of this study was to evaluate the importance of the interhospital transport of critically ill pediatric patients by analyzing the epidemic characteristics of pediatric patients trans- ported from 2009 to 2012. Methods Nine thousand two hundred and thirty-one referral patients from January 2009 to June 2012 were evaluated by a cross-section study. Epidemiological data such as sex, age, seasons, and referral radius were collected. Results Among all the interhospital transport of critically ill pediatric pa- tients,male to female ratio was nearly 2. 24 to 1 and 87. 39% （8067/9231） patients were neonates and in- fants. Of all patients,66. 32% （6122/9231 ） patients were from department of pediatrics, neonatology or gy- naecology and obstetrics in referring hospitals. The distribution of referring department among years was sta- tistically significant in referring patients （ χ2 = 227. 53, P 〈 0. 000 1 ）. Among the patients, 56. 88% （ 5251/ 9231） were transported over 150km radius and only 12. 18% （1124/9231） patients in 50 kin. 52. 89% （4882/9231） were transported in spring and winter. The seasonal distribution of interhospital transport of critically ill pediatric patients was statistically significant（ χ2 = 1201.88 ,P 〈 0. 000 1 ）. The majority of refer- ral telephones were received between 9 AM to 12 AM. Conclusion With the limitation of equipment and technical measure in primary hospitals, critically ill pediatric patients should be transported to tertiary hospi- tals. According to the epidemiological characteristics of interhospital transport of critically ill pediatric pa- tients, some measures should be adopted for the timely, safe and effective interhospital transportation.