危重症新生儿院前转运的急救与护理分析

Emergency treatment and nursing care of critically ill neonates during prehospital transportation

目的探讨危重症新生儿院前转运急救与护理措施的效果。方法选取2018年1月至2021年1月广东省妇幼保健院危重症新生儿2083例为观察对象,在接到转运电话后,立即出车接诊,为患儿实施急救与护理,根据患儿疾病类型分为新生儿内科、外科两组。新生儿内科男613例、女420例,新生儿外科男637例、女413例。分析患儿的一般情况、转运结果、意外拔管率、皮肤损伤发生率。结果转运的危重新生儿中,新生儿内科、新生儿外科的性别、通气情况、转运新生儿类型、日龄、转运路程比较差异均无统计学意义(均P>0.05)。新生儿内科转运成功率为100.00%(1033/1033)、到院后病死率为0.19%(2/1033)、放弃治疗率为0.29%(3/1033)、治愈/好转率为99.52%(1028/1033),新生儿外科转运成功率为100.00%(1050/1050)、到院后病死率为0.10%(1/1050)、放弃治疗率为0.57%(6/1050)、治愈/好转率为99.33%(1043/1050),两组比较差异均无统计学意义(均P>0.05);新生儿内科转运过程中意外拔管率、皮肤损伤发生率与新生儿外科[6.87%(71/1033)比6.19%(65/1050)、3.19%(33/1033)比2.86%(30/1050)]比较差异均无统计学意义(均P>0.05)。结论危重症新生儿院前转运过程中开展急救与护理有利于稳定患儿病情,使患儿得到安全转运,减少不良事件发生,使患儿得到及时救治,改善预后。

Objective To explore the effects of emergency treatment and nursing measures during prehospital transportation of critically ill neonates.Methods From January,2018 to January,2021,2083 critically ill newborns treated at Guangdong Maternal and Children Health Care Hospital from January 2018 to January 2021 were selected as the observation objects.After receiving the transfer call,the team immediately drove out and gave emergency treatment and nursing care to the children.The children were divided into an internal medicine group and a surgical group according to their characteristics.There were 613 males and 420 females in the internal medicine group.There were 637 males and 413 females in the surgical group.The children's general conditions,the transfer results,the incidences of accidental extubation and skin injury were analyzed.Results There were no statistical differences in gender,ventilation,types,age,and transportation distance between the internal medicine group and the surgical group(all P>0.05).The successful transportation rate,mortality after arriving the hospital,treatment-quitted rate,and cured or improved rate were 100.00%(1033/1033),0.19%(2/1033),0.29%(3/1033),and 99.52%(1028/1033)were in the internal medicine group,and were 100.00%(1050/1050),0.10%(1/1050),0.57%(6/1050),and 99.33%(1043/1050)in the surgical group,with no statistical differences between these two groups(all P>0.05).The incidences of accidental extubation and skin injury during the transportation were 6.87%(71/1033)and 3.19%(33/1033)in the internal medicine group,and were 6.19%(65/1050)2.86%(30/1050)in the surgical group,with no statistical differences between these two groups(both P>0.05).Conclusion Emergency treatment and nursing care of critically ill neonates during prehospital transportation are beneficial to stabilize their conditions,and can make them being safely transported,reduce the occurrence of adverse events,treat them timely,and improve their prognosis.