新生儿重症监护室临床危急值报告结果分析

Clinical analysis of critical value reporting system at a neonatal intensive care unit

目的探讨新生儿重症监护室(NICU)危急值的特点及其对临床诊疗的启示。方法收集2012年7月至2012年11月重庆医科大学附属儿童医院新生儿科NICU危急值报告登记本上登记的所有信息完善的危急值病例。调查发生危急值患儿的孕周、出生体重,并分析各危急值项目比例、时间分布、临床应答情况等。结果本调查共有212例NICU患儿的369项危急值,其总体应答率为65.04%;NICU最常见危急值项目是影像学(81项,22.0%)、血糖(79项,21.4%)以及凝血功能(77项,20.9%);标本因素是假阳性危急值的主要原因之一。结论定期对NICU危急值临床资料进行总结,可以根据其特点对临床诊疗方案制定提供依据,并助于制定适合本单位的危急值标准,进而提高临床综合诊疗水平。

Objective To analyze the clinical characteristics of critical values in NICU and help to make the proper diagnosis and treatment plans of NICU.Methods Retrospective analysis was performed on all the critical values in NICU collected from July 1st,2012 to November 30th,2012 in Children′ s Hosptial of Chongqing Medical University. The gestional ages and birth weights of these babies,consitituent ratio of critical index,distribution of report time and clinicalresponse and the impact on treatment were analyzed.ResultsThere were 212 newborns with 369 items of time criticalvalues,and the rate of positive impact on management was 65.04%. Imaging tests（81 cases,22.0%）,blood glucose（79cases,21.4%）and routine coagulation tests（77 cases,20.9%）were the most common critical values. Sample quality wasthe common cause of false positive critical values.ConclusionPeriodically analyzing and summarizing critical values data could help to make a more reasonable critical value system and improve clinical work efficiency andquality.