孝感市医疗机构新生儿医学医疗现状调查分析

目的全面分析湖北省孝感市医疗机构新生儿医学发展现状,为进一步针对性发展、完善新生儿医疗服务提供基础信息及指导。方法通过网络填表直报和现场考察,全面调查2010年孝感市辖区开展新生儿临床诊治的医院医护人员配备、病区建筑布局和设施配置;住院新生儿数、疾病诊断、病情转归及转诊情况;计数资料以构成比或率表示,进行χ2检验,P<0.05为差异有统计学意义。结果孝感市辖区二级以上医院中17家医院开展新生儿临床医疗工作,开放普通病床167张、重症病床11张,医护人员196人,医护比低于卫生部要求,三级医院医护人员与二级医院医护人员学历差异有统计学意义(χ2=9.92,P<0.01)。各医院所开展各种临床常用新生儿诊断操作技术普及率极不平衡。2010年孝感市新生儿病死率1.93%,接近国内发达地区新生儿病死率的水平,新生儿筛查和出生缺陷监测工作全面开展。2010年孝感市新生儿的住院率15.65%,住院病种前五位疾病是新生儿病理性黄疸、新生儿窒息、新生儿肺炎、早产儿、新生儿吸入综合征,占总住院病例数80.16%;不同级别医院的住院疾病构成差异有统计学意义(χ2=469.34,P<0.01);不同县市的新生儿住院率和病死率差异有统计学意义(χ2=322.24,246.48,P<0.01);临床治愈率85.58%,住院新生儿转院率高达10.47%。结论与国内近年报道相比,孝感市新生儿医学的临床水平整体处于落后状况,存在地域差异,人力资源不足,设施设备不齐全,亟待全面加强和提高。

Survey analysis of the development of neonatal medicine of Xiaogan medical institutions

Objective Comprehensive analysis of Xiaogan status of medical institutions in the development of neonatal medicine,targeted for further development and improvement of newborn health care services to provide basic information and guidance.Methods The arrangement of the health care workers,layout of the building of the endemic area and arrangement of the facilities,hospitalization neonate numbers,disease diagnosis,turnover and transfer treatment of the pathogenetic condition were completely researched from the hospital who had evolved the clinical diagnosis of the neonate of Xiaogan in 2010 through straight report by filling the form in network and site inspection.Count data expressed as a proportion or rate,X2 inspection.Results There were seventeen hospitals above the second order who had evolved the clinical diagnosis of the neonate in Xiaogan,Open 167 general ward beds、11 severe beds,196 medical staff.The proportion of doctors and nurses were lower than the Ministry of Health requested,The third class hospital staff and the second class hospital staff qualifications had statistical difference(P<0.01).The hospital carried out a variety of clinical neonatal diagnostic technique penetration is extremely uneven,2010 neonatal mortality of Xiaogan was 1.93%,close to the domestic level of neonatal mortality in developed areas,birth defects in newborn screening and monitoring work carried out.Neonatal hospitalization rate was 15.65% in 2010 in xiaogan,the top five diseases of the first diagnosis were pathological jaundice of newborn,asphyxia of newborn,pneumonia of newborn,premature infant,aspiration syndrome of newborn,80.16% of total inpatient cases.Different level hospital in-patient disease constitutes a difference(P<0.01).Different counties of neonate hospitalization and mortality rates are statistically significant(P<0.01).Clinical cure rate was 85.58%.Referral rate of neonatal hospitalization was up to 10.47%.Conclusions The clinical medicine level of the neonate in Xiaogan had left behind.There are geographical differences.Especially the human resources and equipments are needed to enhance and improve.