4274例新生儿转运临床分析

Clinical analysis of 4 274 cases of neonatal transport

目的新生儿成功有效转运能显著提高患病新生儿救治成功率及预后,发达国家已具备完善救治流程,然而在我国.新生儿转运策略尚未得到广泛重视,本研究旨在评估本院新生儿转运特点及转运过程中需关注问题,提高转运成功率,改善预后。方法对2016年1月1日至2017年12月31日4 274例转运至本院新生儿临床特点及转运途中实施的救治方案进行临床分析-结果新生儿内科3 961例,占92.68%,新生儿外科313例.占7.32%;早产儿683例,占15.98%,足月儿3 591例,占 84.02%;转运时日龄< 24 h 138 例,占 3.23%, 7d 之内 2406 例,占 56.29%, 7 ~ 28 d 1 730 例,占40.48%。均由本院120救护车专业120人员急救转运,转运包括市内转运及长途转运,均位于直径1 200公里之内'新生儿外科疾病中肠梗阻占首位,其次为消化道畸形,新生儿坏死性小肠结肠炎排第3位;新生儿内科疾病谱中前3位疾病分别为:早产儿、重症肺炎、新生儿窒息。转运途中救治措施包括吸氧,强心剂应用,止惊药物应用.葡萄糖注射液应用,吸痰操作,气管插管。转运途中突发事件包括:呕吐,惊厥,呼吸暂停;转运前处理包括:复苏,注氧,液体止惊药物应用「结论新生儿转运在本院已具备相对完善流程,通过转运前充分的准备工作及转运过程中突发情况合理处理,我们建立了比较完善的新生儿转运流程,提高了患儿转运成功率,对改善预后具有重要意义。

Objective Neonatal transport can significantly improve the treatment success rate and prognosis of sick neonates. It is well organized in most developed countries but receives little attention in developing countries. The purpose of this study was to evaluate the characteristics of neonatal transport and the problems needed to be concerned, and to improve the success rate of neonatal transport and the prognosis. Method The clinical characteristics of 4 274 neonates transported to our hospital from January 1, 2016 to December 31, 2017, and the treatment plan implemented in transit were analyzed. Results Of all patients, there were 683 premature infants (15.98%), 3 591 full term infants (84.02%);138 neonates were born within 24 hours (3.23%), 2 406 neonates (56.29%) less than 7 days, and 1 730 neonates (40.48%) 7 to 28 days old;3 961 cases (92.68%) were from neonatal medicine, 313 cases (7.32%) from neonatal surgery. Intestinal obstruction was the most common disease among neonatal surgical diseases, followed by digestive tract malformation, and neonatal necrotizing enterocolitis. The first three diseases in neonatal internal medicine diseases were premature infants, severe pneumonia, and neonatal asphyxia. In transit, the treatment measures included oxygen inhalation, application of cardiac stimulant, anticonvulsant drug application, application of glucose injection, sputum aspiration operation, tracheal intubation. Sudden events in transit included vomiting, convulsions, apnea. Pre-transport care included resuscitation, intravenous fluid, supplemental oxygen, anticonvulsant drug application. Conclusions Neonatal transport process was well organized in our hospital. It was of great significance to improve the prognosis of the neonates in the process of preparation before and during the transit.