新生儿重症监护病房高危儿出院后随访依从性调查研究

Follow-up compliance of high-risk neonates in neonatal intensive care unit after discharge

目的调查新生儿重症监护病房(NICU)高危新生儿出院后随访现状,分析影响高危儿随访依从性的相关因素。方法本课题采取前瞻性研究方法,对孝感市中心医院新生儿科NICU 2014年1月至2016年6月出院的高危儿进行随访,并对住院病例资料和门诊随访进行整理记录,计算高危儿随访的依从性,对影响高危儿随访依从性的相关因素进行分析。结果纳入研究高危儿758例,随访依从性好116例(15.30%),随访依从性差642例(84.70%);出生胎龄≤32周组患儿随访依从性好的比例高于出生胎龄32~37周组和≥37周组,不同胎龄组患儿的随访依从性比较,差异有统计学意义(X^2=13.227,P=0.001);出生体质量<1000 g组患儿随访依从性好的比例为83.33%,高于出生体质量1000~1500 g组、1500~2500 g组和≥2500 g组,不同出生体质量组患儿的随访依从性比较,差异有统计学意义(X^2=112.420,P=0.000);新生儿重度窒息(脑病)随访依从性好的比例为54.29%,高于其他疾病组的随访依从性,不同主要疾病种类随访依从性比较,差异有统计学意义(X^2=37.027,P=0.000)。结论本院NICU高危儿出院随访依从性较差,出生胎龄和体质量越小随访依从性越好,不同疾病高危儿的随访依从性差异较大,高危儿出院随访宣教亟待加强。

Objective To investigate the follow-up status of high-risk neonates in neonatal intensive care unit(NICU)after discharge,and analyze the relevant factors affecting the follow-up compliance of high-risk neonates.Methods This subject adopts the prospective research method to follow up the high-risk infants discharged from NICU,Department of Neonatology,Xiaogan Central Hospital from January 2014 to June 2016.The data of hospitalized cases and outpatient follow-up were collated and recorded.The compliance of follow-up of high-risk infants was calculated,and the related factors affecting the compliance of follow-up of high-risk infants were analyzed.Results 758 high-risk infants were included in the study.116 cases(15.30%)had good follow-up compliance and 642 cases(84.70%)had poor follow-up compliance.Comparing the follow-up compliance of high-risk infants in different gestational age groups,the results showed that the good follow-up compliance rate of infants with gestational age(<32 weeks)was higher than that of infants with gestational age(32-37 weeks)and(>37 weeks).There was significant difference in the followup compliance of infants with different gestational age groups(X^2=13.227,P=0.001).Comparisons of good follow-up compliance rate among highrisk infants in different birth weight groups showed that 83.33%of the children with birth weight<1000 g had higher good follow-up compliance rate than those in 1000-1500 g group,1500-2500 g group and≥2500 g group.There was significant difference in follow-up compliance between different birth weight groups(X^2=112.420,P=0.000).Comparisons of good follow-up compliance rate of high-risk infants in different disease groups showed that the main disease was severe asphyxia neonatorum(encephalopathy),which was 54.29%,higher than that of other disease groups,there was significant difference in the follow-up compliance of different major diseases(X^2=52.318,P=0.000).Conclusion The follow-up compliance of NICU high-risk infants is low.The lower the birth age and weight,the better the follow-up compliance.The follow-up compliance of NICU high-risk infants with different diseases varies greatly.The follow-up education of high-risk infants needs to be strengthened urgently.