区域内危重新生儿转运体系的应用研究

Application of regionalized critical neonatal emergency transport system

摘要:

目的：了解区域内危重新生儿转运现状及存在的问题，为建立区域内完善的新生儿转运体系提供参考。方法：选取2009年1月至2010年9月北京海淀区4所医院所有转诊新生儿为研究对象，并收集2所接诊医院的相关临床资料进行研究。结果：转诊疾病以早产儿、需外科急诊处理的疾病和呼吸系统疾病为前3位疾病（33.1%、18.3%、14.8%）。主动转诊95例（66.9%），被动转诊47例（33.1%）。转诊时年龄＜6 h者占 24.1%，6 h~者占9.3%，12 h~者占25.9%，>24 h者占40.8%。从医院乘救护车至接诊病房时间为28.0±11.1 min。转诊后死因以需外科急诊治疗的疾病占第1位，占死亡病例的53.8%。转诊时年龄<6 h组和≥6 h 组的死亡率差异无统计学意义。结论：本研究区域内4所医院以主动转运为主。需手术治疗的外科疾病患儿转诊后死亡率高，应重视新生儿外科疾病患儿的转运工作。

Abstract:

OBJECTIVE: To study the application of the regional critical neonatal emergency transport system (NETS) to provide evidence for the optimization of NETS in Beijing. METHODS: All the transported neonates in four hospitals in Haidian District, Beijing, between January 2009 and September 2010 were enrolled. The relevant clinical information of two referral hospitals was analyzed. RESULTS: The top three conditions requiring transport were pre-term delivery, diseases requiring surgical treatment, and respiratory diseases, which accounted for 33.1%, 18.3%, and 14.8%, respectively. Active transport was performed in 95 cases (66.9%) and passive transport in 47 cases (33.1%). The age distribution of the neonates requiring transport was as follows: 24 hrs (40.8%). The mean time for transport from the hospital to a referral ward by ambulance was 28.0±11.1 minutes. Diseases requiring emergency surgical treatment were the leading cause of death, accounting for 53.8% of total deaths. The mortality rate was not significantly different between the neonates aged <6 hrs and ≥6 hrs groups. CONCLUSIONS: Active transport remains the main transport pattern among these four hospitals. Neonates requiring surgical treatment have a high mortality rate, and thus special attention should be paid to their transport.