区域内危重新生儿转运体系的应用研究

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。

Application of regionalized critical neonatal emergency transport system

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: <6 hrs after birth(24.1%);6-12 hrs(9.3%);12-24 hrs(25.9%);and >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.