住院不足24小时出院新生儿的现状分析

Status Analysis of Neonatus in Hospital Less than 24Hours

目的探讨住院不足24h出院新生儿的现状,以了解其出院原因。方法采用回顾性分析法对2007年1月1日至2011年12月31日于湖北省孝感市中心医院新生儿科住院不足24h出院的379例新生儿的临床病历资料进行相关统计学分析。本研究遵循的程序符合湖北省孝感市中心医院人体试验委员会所指定的伦理学标准,得到了该委员会批准,分组征得受试对象父母的知情同意,并与之签署临床研究知情同意书。结果本组379例新生儿中,①出院原因包括:放弃治疗为122例(32.2%),转院为125例(33.0%),好转出院为94例(24.8%),未愈出院为38例(10.0%)。②本组居前4位的疾病为:呼吸系统疾病占45.9%(174例),早产为占35.3%(134例),神经系统疾病占18.5%(70例),出生缺陷占12.7%(48例)。③自2007至2011年5年间住院不足24h出院新生儿的出院疾病状况构成比比较,每年住院不足24h因疾病危重放弃治疗而出院的新生儿呈逐年下降趋势,5年间比较,差异有统计学差异(χ2=6.115,P=0.013)。5年间未愈出院的新生儿呈逐年上升趋势。转院、好转及未愈新生儿的出院率比较虽有波动,但差异均无统计学意义(P>0.05)。④5年间住院不足24h出院新生儿出院原因比较,因病情无望导致的出院率呈逐年下降趋势,5年间比较,差异有统计学意义(χ2=6.922,P=0.009);误解病情、建议转院、经济困难、不满服务、怀疑医术,5年间比较,差异均无统计学意义(P>0.05)。结论导致住院不足24h新生儿出院既有医疗本身原因亦有社会因素。增加新生儿科硬件配置及医护人员配置,努力提高医院的医疗技术水平,提高服务质量和改善服务态度,完善社会保障机制,可降低住院不足24h未愈新生儿的出院率,提高本地区新生儿救治率和人口生存质量。

Objective To investigated the current status and reasons to discharge of neonatus in hospital less than 24 h. Methods From January 2007 to December 2011, a total of 379 neonatus in hospital less than 24 h in Xiaogan Central Hospital, Hubei Province, were retrospective analyzed. Their related clinical data were analyzed by statistical methods. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Xiaogan Central Hospital. Informed consent was obtained from the parents of each participating neonate. Results （1）among 379 neonatus being in hospital less than 24 h, 122 cases（ 32.2 % ） were gave up treatments, 125 cases （33.0 % ） were hospital referral, 94 cases（ 24.8 % ） were improved and 38 cases（10.0%）were not cured. （2） The top four diseases of 379 neonatus being in hospital less than 24 h were respiratory system diseases（45.9%）, preterm infants（35.3%）, birth defects （12.7%） and infectious diseases（12.1% ）. （3） Comparison of constituent ratio of disease status among 379 neonatus in hospital less than 24 h from 2007 to 2011, rate of abandon treatment was descend year by year, there had statisticallydifference（x2=6. 115,P=0.013）. the incidence rate of not cured was risen year by year,and there had statistically difference（P〈0.05）, neonatus in hospital less than 24 h caused by hospital referral, improved were fluctuation, but no descend or rise tendency during this 5 years,and there had no statistically differenee（P）0.05）. （3） Comparison of constituent ratio of reasons among 379 neonatus in hospital less than 24 h from 2007 to 2011, rate of hopeless was descend year by year（x2 trend test x2=6. 922,P =0. 009）. neonatus in hospital less than 24 h caused by misunderstanding pathogenetic condition, being suggested hospital referral, financial straits, underfill service and suspect leechcraft in this hospital were no descend or rise tendency during this 5 years, and there had no statistically difference （P〉 0. 05 ）. Conclusions There were various medical and social reason in neonatus being in hospital less than 24 h. Weshould add hardware configuration and medical personnel to the neonate department, improve the autologous medical level arduous, quality of service and attitudes, consummate social aid mechanism, decreased the hospital discharge rate of the hospitalization less than 24 h, improve the level of the local neonatus medical service and the naonatus remedy skills and the life quality, strengthen the health care consciousness and popular neonatal disease.