新生儿重症监护室环境布局对极/超早产儿临床结局及神经发育的影响

Impact of the environmental layout of the neonatal intensive care unit on clinical outcomes and neurological development in very/extremely preterm infants

摘要:

目的 探讨新生儿重症监护室（neonatal intensive care unit，NICU）环境布局对极/超早产儿临床结局及神经发育的影响。方法 选取重庆医科大学附属儿童医院2021年1月—2022年6月收治、生后24 h内入院的304例极/超早产儿为研究对象。采用回顾性队列研究方法，根据NICU不同环境布局将患儿分为两组，即集中式布局组（157例）和分散式布局组（147例），比较两组患儿临床结局和校正胎龄34~51⁺⁶周时婴儿运动表现测试评分结果。结果 分散式布局组支气管肺发育不良（44.9% vs 62.4%）和颅内出血（17.7% vs 28.0%）的发生率低于集中式布局组（均P<0.05）；分散式布局组治愈率高于集中式布局组（68.7% vs 56.7%，P<0.05）。在校正胎龄34~51⁺⁶周时，分散式布局组婴儿运动表现测试评分高于集中式布局组（P<0.05）。结论 NICU分散式环境布局较集中式布局在极/超早产儿临床结局及早期神经发育方面显示出积极的影响。

Abstract:

Objective To investigate the impact of the environmental layout of the neonatal intensive care unit (NICU) on clinical outcomes and neurological development in very/extremely preterm infants.Methods A total of 304 very/extremely preterm infants admitted to Children's Hospital of Chongqing Medical University between January 2021 and June 2022 within 24 hours after birth were included in this retrospective cohort study. Based on different environmental layouts in the NICU, the infants were divided into two groups: centralized layout group (n=157) and decentralized layout group (n=147). The clinical outcomes and Test of Infant Motor Performance (TIMP) scores at corrected gestational age between 34 to 51⁺⁶ weeks were compared between the two groups.Results The decentralized layout group had lower incidence rates of bronchopulmonary dysplasia (44.9% vs 62.4%, P<0.05) and intracranial hemorrhage (17.7% vs 28.0%, P<0.05) than the centralized layout group. The cure rate was higher in the decentralized layout group compared to the centralized layout group (68.7% vs 56.7%, P<0.05). The decentralized layout group had higher TIMP scores than the centralized layout group at corrected gestational age between 34 to 51⁺⁶ weeks (P<0.05).Conclusions The decentralized layout of the NICU exhibits positive effects on the clinical outcomes and early neurological development compared to the centralized layout in very/extremely preterm infants.