摘要
目的探讨建立地区性主动型新生儿转运系统(NETS)及新生儿重症监护室(NICU)在提高新生儿救治水平中的作用。方法通过实施NETS,将2004年1月1日至2011年12月31日入住扬州市第一人民医院NICU的新生儿分为通过NETS转运至NICU、院外非NETS收住NICU、本院产科转入NICU共3组,分析新生儿死亡率、死亡原因及其差异。结果 2004-2011年共住院新生儿8 168例,死亡138例,新生儿死亡率为1.69%,按时间段分为转运前期(2004-2007年)和转运后期(2008-2011年),前、后4年死亡率分别为1.76%和1.64%,经比较有下降趋势,但差异无统计学意义(P>0.05)。通过NETS转运至NICU的新生儿死亡率为4.90%,比院外非NETS收住NICU新生儿的死亡率(9.64%)明显降低,差异有统计学意义(χ2=12.460,P=0.000);与本院产科转入NICU新生儿死亡率(4.73%)相比,差异无统计学意义(P>0.05)。后4年通过NETS转运至NICU的新生儿死亡率(4.26%)比前4年死亡率(9.88%)明显降低,差异有统计学意义(χ2=4.869,P=0.027)。转运后期院外非NETS收住NICU的新生儿死亡率为9.84%、本院产科转入NICU新生儿死亡率为3.87%,与转运前期的9.46%和5.96%相比,差异均无统计学意义(均P>0.05)。死亡原因主要为早产,各组间无差异。结论 NICU提高了新生儿急救管理水平,NETS能够降低新生儿死亡率。
Objective To evaluate the effect of active regional neonatal emergency transport system （NETS） construction and neonatal intensive care unit （NICU） on improving neonatal treatment level. Methods Through implementation of NETS, neonates admitted to NICU of the First People＇ s Hospital of Yangzhou from January 1, 2004 to December 31, 2011 were divided into 3 groups, neonates transported to NICU by NETS, neonates admitted into NICU from outside hospital but not transported by NETS, and neonates transferred to NICU from obstetrics department in the hospital. Neonatal mortality rate, cause of death and the differences were analyzed. Results Among 8 168 neonates hospitalized in the hospital from 2004 to 2011, 138 neonates died, and neonatal mortality rate was 1.69%. The neonates were divided into cases before NETS establishment （2004 -2007） and cases after NETS establishment （2008 -2011 ） based on time. Neonatal mortality rate in former and later four years was 1.76% and 1.64% respectively. Comparison of mortality rate showed a decreasing tendency but difference had no statistic difference （P 〉 0.05）. Mortality rate of neonates transported to NICU through NETS was 4.90%, which was greatly lower than that （9.64%） of neonates transported to NICU from outside hospital without NETS, and the difference had statistical significance （X2 = 12. 460, P = 0. 000 ）. But compared to the mortality rate of neonates transferred to NICU from obstetrics department （4.73%）, the difference had no statistical significance （P 〉 0.05）. Mortality rate of neonates transported to NICU by NETS in later four years （4.26%） was significantly lower than neonatal mortality rate in former 4 years （9.88%）, and the difference was statistically significant （x2 = 4. 869, P = 0. 027 ）. After establishment of NETS, mortality rate of neonates transported from outside hospital to NICU without NETS was 9.84% and that of neonates transferred to NICU from obstetric department inside the hospital was 3.87% , which were not significantly different from those （9.46%, 5.96% ） before establishment of NETS （all P 〉 0.05 ）. The main cause of neonatal death was premature birth and there was no difference in each group. Conclusion NICU improves neonatal emergency treatment management level. NETS can help to reduce neonatal mortality rate.
出处
《中国妇幼健康研究》
2017年第1期32-34,共3页
Chinese Journal of Woman and Child Health Research
关键词
新生儿
转运系统
重症监护
死亡率
neonates
neonatal emergency transport system
intensive care units
mortality rate
作者简介
王伏东（1977-），男，副主任医师，主要从事新生儿疾病的诊疗工作。
[通讯作者]符明凤，主任医师。
