探讨儿童急救网络建设对危重患儿急救的治疗效果

Observation on effect of Children′s first aid network construction in emergent treatment of critically ill children

目的探讨儿童急救网络建设对危重患儿急救治疗效果。方法对该院2013年1月至2014年6月实施院前急救网络转运的患儿728例的临床资料进行回顾性分析,分析儿童基本情况、救治覆盖半径和疾病构成情况。同时选择2011年7月至2012年12月非网络院前转运危重患儿作对照,比较两组救治效果。结果 728例危重患儿包括新生儿372例,婴儿144例,幼儿85例,学龄前儿童65例,学龄儿童62例。728例急救患儿中排名前10位的病种分别为早产儿、重症肺炎、新生儿窒息、急腹症、惊厥、新生儿胎粪吸入性肺炎、腹泻、新生儿呼吸窘迫综合征、新生儿肺出血、重症哮喘。与非网络院前转运危重患儿比较,院前急救网络转运患儿24h内病死率明显降低(P<0.05),两组痊愈率、24h后病死率比较,差异无统计学意义(P>0.05)。结论儿童急救网络建设可以有效发挥医院的优势,实现常见病、多发病就地治疗,危重病及时转运的协同机制,有效提高儿童危重症救治效果,降低致残率和病死率。

Objective To investigate the effect of the children′s first aid network construction in the emergency treatment of critically ill children.Methods The clinical data in 728 transferred children patients by implementing the pre-hospital first aid network in our hospital from 2013 January to 2014 December were retrospectively analyzed.The basic situation,treatment coverage radius and the diseases constitution were analyzed.At the same time non-network pre-hospital transferred selected the 2011 July to 2012 December non-network pre-hospital transferred critically ill children were selected as the control group.The treatment effects were compared between the two groups.Results 728 cases of critically ill children,including 372 neonates 144infants,85 young children,65 preschool children and62school-age children.Among 728 first aid children patients,the top 10 disease entities were preterm infants,severe pneumonia,neonatal asphyxia,acute abdomen,convulsion,neonatal meconium aspiration pneumonia,diarrhea,neonatal respiratory distress syndrome,neonatal pulmonary hemorrhage and severe asthma.Compared with non-network pre-hospital transferred critically ill children patients,the 24 h mortality rate in the pre-hospital first aid network transferred children patients was significantly decreased（P〈0.05）,the cure rate and the mortality rate after 24 h had no statistically significant differences between the two groups（P〉0.05）.Conclusion The children′s first aid network construction can effectively play the advantage of hospital,realizes the collaborative mechanism of local treatment for common diseases and frequently occurring diseases,and timely transferring for critically ill,effectively improves the treatment effect of critical diseases in children and reduces the disability rate and mortality rate.