摘要
目的：探讨呼吸衰竭早产儿转运时机与临床结局的相关性，了解Ⅱ级新生儿病房危重早产儿的转运时机。方法收集2013年1月1日至12月31日湖南省儿童医院新生儿重症监护病房收治的Ⅱ级新生儿病房需呼吸支持（有创和无创）早产儿的临床资料，根据患儿在Ⅱ级新生儿病房呼吸支持的情况分为非规范转运组和规范转运组，对2组患儿入院时的一般资料、上机时间、氧暴露时间、支气管肺发育不良（BPD）发生率、治愈好转率、住院时间、总住院时间（当地住院时间＋入院后住院时间）及住院费用进行回顾性分析。结果纳入的363例病例中，非规范转运组107例，规范转运组256例。非规范转运组上机时间为（19.75±19.53）d、氧暴露时间为（30.60±24.80）d、BPD 发生率为57.01%（61/107例）、治愈好转率为70.10%（75/107例）、住院时间为（43.99±28.08）d、总住院时间为（59.50±34.02）d、住院费用为（6.55±4.30）万元；规范转运组上机时间为（13.02±12.64）d、氧暴露时间为（19.50±19.24）d、BPD 发生率为18.36%（47/256例）、治愈好转率为83.20%（213/256例）、住院时间为（32.79±23.76）d、总住院时间为（34.48±23.69）d、住院费用为（4.99±4.12）万元。非规范转运组上机时间长、氧暴露时间长、BPD 发生率高、治愈好转率低与规范转运组比较差异均有统计学意义（t =18.706、t =6.883、χ2=53.934、χ2=7.912，P 均﹤0.05）；非规范转运组住院时间和费用与规范转运组比较差异无统计学意义（t =2.012、0.552，P 均﹥0.05），但总住院时间比较差异有统计学意义（t =22.967，P ﹤0.05）。结论非规范转运组住院时间长、BPD 发生率高、治愈好转率低；2013年版中国新生儿病房分级建设与管理指南（建议案）具有合理性，Ⅱ级新生儿病房应严格按照其进行区域性新生儿转运。
Objective To investigate the correlation between the transport time of preterm infants with respira-tory failure and the clinical outcome. And to determine the transit time in critically ill premature infants. Methods Premature infants in level Ⅱ neonatal ward in Hunan Province Children＇s Hospital from January 1 to December 31, 2013,admitted to the Neonatal Intensive Care Unit requiring respiratory support（invasive and noninvasive）,were re-viewed. All the patients were classified into non - standardized transport group and regulate transport group according to respiratory support that infants in the level Ⅱ neonatal ward required. Data on general information,the time of ventilator application,the time of exposure to oxygen,morbidity of bronchopulmonary dysplasia（BPD）,the cure and improvement rate,length of stay,the total length of stay（length of stay in the local hospital and our hospital）,and hospitalization ex-penses were collected. Results Among the 363 infants,there were 107 cases in the non - standardized transport group, and 256 cases in the regulate transport group. The time of ventilator application in the non - standardized transport group was longer than that in regulate transport group[（19. 75 ± 19. 53）d vs（13. 02 ± 12. 64）d,t = 18. 706,P ﹤ 0. 05],the time of exposure to oxygen was longer[（30. 60 ±24. 80）d vs（19. 50 ±19. 24）d,t =6. 883,P ﹤0. 05],the morbidity of BPD was higher[57. 01%（61/ 107 cases）vs 18. 36%（47/ 256 cases）,χ2 = 53. 934,P ﹤ 0. 05],but the cure and im-provement rate was lower[70. 10%（75/ 107 cases）vs 83. 20%（213/ 256 cases）,χ2 = 7. 912,P ﹤ 0. 05],and the total length of stay was longer[（59. 50 ± 34. 02）d vs（34. 48 ± 23. 69）d,t = 22. 967,P ﹤ 0. 05]than that in the regulate group. But there was no significant difference between the length of stay[（43. 99 ±28. 08）d vs（32. 79 ± 23. 76）d,t =2. 012,P ﹥0. 05]in the non - standardized transport group and regulate transport group,with the hospitalization expenses [（6. 55 ±4. 30）vs（4. 99 ±4. 12）thousands yuan,t =0. 552,P ﹥0. 05]. Conclusions The non - standardized transport group has higher morbidity of BPD,but lower cure or improvement rate,and it has longer length of stay. The 2013 edition of Chinese Neonatal Ward Hierarchical Construction and Management Guide（Proposal）is reasonable,level Ⅱ neonatal ward should be in strict accordance with it to transport regional neonatal.
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2015年第14期1087-1089,共3页
Chinese Journal of Applied Clinical Pediatrics
基金
湖南省医药卫生科研计划项目（B-2014-126）
关键词
婴儿
早产
呼吸衰竭
机械通气
支气管肺发育不良
新生儿转运
Infant,premature
Respiratory failure
Mechanical ventilation
Bronchopulmonary dysplasia
Neonate transfer
