摘要
目的了解国内新生儿转运开展现状。方法采取调查表形式对109家医院NICU新生儿转运情况进行调查分析。结果109家医院平均新生儿床位为35．95张（6—300张，中位数30张），2008年共收治139084例，平均收治人数为1276例（32～5500例，中位数1160例）。有62家（56．9％）医院已开展新生儿转运，转运半径为5—800km。最早开展转运时间为1987年，72．6％医院在2000年后才开展转运。在开展转运的62家医院中，56．5％配备有转运暖箱，80．7％有新生儿转运车，98．4％有专用的转运电话，74．2％在转运实施前有完善的评估措施，45．2％可开展双向转运。转入的主要病种依次为早产、新生儿窒息、呼吸窘迫综合征，转出病种主要为需要外科干预的先天畸形、先天性心脏病及严重呼吸衰竭患儿。转运途中主要处理措施依次为保暖、给氧、气管插管和心肺复苏。54家提供数据的医院2008年平均转运330人次，最多5130例，整体途中病死率为0．39％o。50家医院提供了转运患儿占年总收治患儿的比例数据，平均比例为20．28％。开展转运医院在设备配置、技术开展方面均明显优于未开展转运医院。结论国内新生儿转运发展迅速，但在转运设备、转运方式选择、技术开展、区域性三级转诊体系建立方面仍有待改进。
Objective To investigate the present situation of emergency transport of newborns in the mainland of China in order to understand the fully utilization of good medical resources. Methods Data collected in 2009 by questionnaires from neonatal subspecialty of 109 hospitals in 22 cities across whole country about transport of newborns referred to other hospitals with better facilities, higher technology, bigger bed capacities and well qualified pediatricians were analyzed. Results The average number of neonatal beds in 109 hospitals was 35.95 （ranging from 6 to 300, median 30）. Total 139 084 infants were treated in 109 hospitals in 2008, with the average number of 1276 （ranging from 32 to 5500, median 1160）. Of 109 hospitals, 62 （56. 9% ） hospitals provided transport service. The longest distance of transport varied among different hospitals ranged from 5 km to 800 kin. The initiation of transport service was launched out in 1987, but 45 hospitals （ 72.6% ） lagged behind in offering transport service until later after 2000. Of those hospitals providing transport service, 35 （56. 5% ） were equipped with transport incubator, 50 （80. 7% ） with neonatal transport vehicle, 61 （98.4%） with telephones exclusive for transport call, 46 （74. 2% ） with procedure of good pre-transport assessment, and 28 （45.2%） with bidirectional transportation. The main diseases admitted into were premature birth, neonatal asphyxia and respiratory distress syndrome, and the diseases for transport out were congenital malformation and congenital heart disease needed surgical intervention, and severe respiratory failure. The essential care measures for newborns during transport were keeping body warm, supplying oxygen, and intubation and CPR just in ease. Data from 54 hospitals showedthe average number of transport was 330 in 2008, and the largest number reached 5130 infants in a hospital. The total mortality during transport was 0. 39%e. The mean rate of transport of infants of 50 hospitals accounted for 20. 28% of total admissions. Hospitals carried out transport service were significantly better in facilities and techonology than those without transport service. Conclusions Transport service for newborns has developed quickly in new millennium in the China's Mainland, but there are still many shortcomings called for improvement, including transport equipments, modality of transport, development of technology and optimization of regional medical hierarchy system for transfer of newborns referred from primary hospital to secondary one and further to tertiary hospital.
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2013年第5期459-463,共5页
Chinese Journal of Emergency Medicine
基金
卫生部妇社司专项基金[卫妇社儿卫便函（2009）8]
关键词
新生儿
转运
新生儿重症监护
调查
Newborns
Transport
Neonatal intensive care
Survey
