区域性危重新生儿转运十年变化对比分析

Analysis of ten years changes of regional critical neonatal transport

目的分析2007年与2018年区域性危重新生儿转运的变化情况,为进一步提高陕西省区域危重新生儿转运水平、降低新生儿死亡率提供参考。方法对2007年与2018年由西北妇女儿童医院新生儿重症监护病房(NICU)转运的(含该院转运系统转运、转出单位自行转运、家庭医生转运)危重新生儿进行回顾性分析。结果2007年危重新生儿转运共457例,治愈好转382例,放弃治疗63例,死亡12例;2018年危重新生儿转运共516例,治愈好转479例,放弃治疗33例,死亡4例;2018年患儿治愈好转率显著高于2007年(χ^(2)=20.32,P<0.05)。2018年危重新生儿转运例数高于2007年,转自三级医院患儿分布高于2007年(χ^(2)=13.93,P<0.01)。2018年患儿转运胎龄低于2007年(t=3.62,P<0.05)。在危重新生儿转运的疾病中,2007年前三位分别为早产儿(31.5%)、新生儿窒息(29.3%)、吸入性肺炎(11.4%),2018年前三位分别为早产儿(20.2%)、呼吸窘迫综合征(12.2%)、新生儿窒息(10.3%)。结论区域性危重新生儿转运有助于推动新生儿危重症救治水平的提高;需进一步加强宫内转运;规范转运体系的管理,降低危重患儿的病死率且减少并发症。

Objective To analyze the changes of regional critical neonatal transport in 2007 and 2018,and to provide ideas for further improving the level of regional critical neonatal transport and reducing neonatal mortality in Shaanxi province.Methods A retrospective analysis for critical neonates was conducted in 2007 and 2018 in neonatal intensive care unit(NICU)of Northwest Women′s and Children′s Hospital(including critical neonates transferred by the hospital′s transfer system,transferred by the transfer units,and transferred by family doctors).Results In 2007,457 critical neonates were transferred,382 were cured,63 were given up treatment and 12 died.A total of 516 cases were transferred in 2018,of which 479 were cured,33 were given up treatment and 4 died.There was a significant difference in recovery rate between the two groups(χ^(2)=20.32,P<0.05).The number of neonates transferred in 2018 increased compared with 2007,and more neonates were transferred from tertiary hospitals than in 2007(χ^(2)=13.93,P<0.01);The average gestational age of transfers in 2018 were lower than that in 2007(t=3.62,P<0.05);The top three transport diseases in 2007 were premature infants(31.5%),neonatal asphyxia(29.3%)and aspiration pneumonia(11.4%).The top three transport diseases in 2018 were premature infants(20.2%),neonatal respiratory distress syndrome(12.2%)and neonatal asphyxia(10.3%).Conclusion Regional transfer of critical neonate is conducive to the improvement of the treatment level of critical newborns.It is necessary to further strengthen intrauterine transport and standardize the management of the transport system to reduce the mortality rate of critical neonates and reduce complications.