新生儿转运过程的救护

目的：讨论如何在新生儿转运过程中，对患儿出现的情况进行救护。方法：通过电话向当地医院了解患儿情况，准备急救用品，到院后根据病情对患儿进行各种基础及对症处理。结果：转运过程中病情相对稳定的有3473例，恶化63例，死亡11例，另有20例在转运到院后2h内死亡。结论：恰当地在当地进行即时处理，是转运成功的关键，同时应重视转运途中的救护。     

广东省新生儿转运现状分析

目的 了解广东省新生儿转运开展、转运评估和转运病种情况.方法 于2007年1月至5月对广东省共146家各级医院新生儿科进行问卷调查,输入电脑数据库进行分析.结果 广东省新生儿转运在近三年得到明显普及,转运率为55.5%,三级医院开展新生儿转运率(66.7%)要明显高于一级医院(42.2)%,差异有显著性(χ2=4.309,P<0.05).一级、二级和三级医院分别有40.0%、45.1%和56.7%开展转运评估,分别有20.0%、30.9%和33.3%采用规范化转运表,各级医院间转运评估率和规范化转运表使用率差异无显著性(P>0.05).一级和二级医院的转诊疾病以早产儿、低出生体重儿等传统疾病为主,三级医院则以外科疾病为主.结论 必须规范新生儿转运的准入制度、评估和转运流程.在有条件的医院可开展新生儿外科,以提高对新生儿外科疾病的救治水平.     

新生儿转运过程的救护

目的　 讨论如何在新生儿转运过程中 ,对患儿出现的情况进行救护。 方法 　通过电话向当地医院了解患儿情况 ,准备急救用品 ,到院后根据病情对患儿进行各种基础及对症处理。 结果 　转运过程中病情相对稳定的有 3 4 73例 ,恶化 63例 ,死亡 11例 ,另有 2 0例在转运到院后 2h内死亡。 结论 　恰当地在当地进行即时处理 ,是转运成功的关键 ,同时应重视转运途中的救护     

危重新生儿转运模式及其应用研究

目的探索适合中国国情的危重新生儿转运模式与方法。方法对我院转运的1210例危重新生儿进行回顾性研究,并对新生儿转运系统(NETS)内的19家基层医院新生儿病死率进行分析。结果本组病例转运单程多在5～100公里(占97.7%),最远200公里;往返时间一般0.5～4.0小时,最长12小时。转运成功率、转运途中病死率、转运病死率、总治愈率和病死率分别为93.2%、0.3%、1.4%、96.4%和6.7%。19家基层医院新生儿病死率由1994年的17.9%降低至1997年的9.3%。结论在新生儿加强医疗病房基础上,与基层医院密切联系,建立NETS,采用地面双程转运方式进行新生儿转运,是适合我国国情的危重新生儿转运模式。     

新生儿区域转运与NICU

目的：探讨区域转运与NICU的关系。方法：通过转运危重新竽儿的数字,病种分布及其抢救成功率,对区域转运与NICU进行分析。结果：4年间NICU收治危重患儿1080例,其中从外院转运的患儿占923例（85.46%）;抢救成功991例（91.76%),死亡17例（1.58%）,放弃72例（6.66%)。结论：建立有效的区域转运,可使NICU资源得到充分利用,大大提高危重患儿的抢救成功率;同时建立NICU也为转运提供了坚实的后盾。     

418例危重新生儿转运分析

目的研究危重新生儿转运对提高危重新生儿的抢救成功率，降低新生儿病死率的影响。方法建立沧州市中心医院危重新生儿转运系统，将沧州市所辖15个县市40多家医院产、儿科组成转运网络，对危重新生儿进行转运，部分进行转运前危重病例评分，开展了宫内转运及反向转运。结果我院4年来转运418例危重新生儿，途中无一例死亡，转运后死亡14例，自动出院12例，抢救成功率96．6％。宫内转运26例均成活，成功率100％。反向转运22例，无一例死亡，成功率100％。110例进行新生儿危重病例评分，危重组69例，成活66例，成活率96％；极危重组11例，成活5例，成活率45％。结论迅捷安全的转运工作有效地降低了危重新生儿的病死率。     

危重新生儿转运过程中的急救护理

目的 探讨危重新生儿转运过程中的急救护理措施。方法 通过转运系统将基层医院危重新生儿转运至我院，转运前物品准备，病情稳定处理，途中生命体征监测和救护。结果 转运高危新生儿430例，转运过程中病情相对稳定有415例、恶化9例、死亡1例、到院后1h内死亡5例。408例治愈好转出院，放弃12例、死亡10例。结论 转运前稳定病情、转运途中监测与救护，是危重新生儿成功转运的关键环节。     

危重新生儿转运中的护理

新生儿转运系统在发达国家相当普遍。其主要目的是有计划、有组织、有领导地将基层医院产科、儿科与某些大医院或医疗中心的NICU联合起来，及时地把基层医院产科分娩的高危新生儿转运到NICU中，使高危儿得到最好的治疗及护理。对降低新生儿病死率和伤残率起了积极的作用。我国目前尚未广泛开展这项工作。我院自1995年8月～1996年5月，共接运196例危重新生儿，现就有关护理谈几点体会。临床资料1．一般资料：本组共196例。男142例；女54例；出生体重＜1000克4例（2．04％）；～1500克35例（178％）；～2500克10例（5.10％）；～3000克120…     

区域性危重新生儿的转运与降低新生儿死亡率

我国新生儿死亡占５岁以下儿童死亡的５８４％［１］，降低新生儿病死率对降低５岁以下儿童病死率意义重大。１９９３年下半年起，我院在国内率先建立新生儿转运网络，１９９４～１９９６年共转运患儿７５９例。现将开展情况报告如下。资料及方法：１转运设备包括新生...     

94例危重新生儿转运体会

高危新生儿的急救应包括现场急救、路途转运和医院重症监护病房三大部分 ,这三个部分必须密切配合才能发挥巨大的抢救效能。我院省新生儿急救中心自 1 999年 1月起建立合肥地区危重新生儿急救转运网络 ,现将 94例危重新生儿转运情况报告如下 :转运系统组成一、转运抢救人员我院新生儿急救中心设有专线急救转运电话 ,病房有一批 NICU工作人员 ,2 4小时随时出诊 ,每次出诊有一名 NICU主治医师或主治以上医师和一名 NICU专业护士 ,专职司机。二、转运病人来源合肥地区 1 6家基层医院 ,一般在 2 0公里以内最远为 1 30公里。三、转运设备日…     

A population based 10-year study of neonatal air transport in North Norway

AIM: This study audits the activity of the neonatal air transport team in Norway's two northernmost counties. METHODS: Data on all air transports to or from the regional Neonatal Intensive Care (NICU) Unit within a 10-year period were collected. RESULTS: Two hundred and thirty-eight acute transports were conducted during the study period; 169 referrals to the NICU and 69 transfers to national surgical and cardiac centres. Only 13 very low birth weight infants were transported; the in utero transport rate was 95% for this patient population. The adjusted risk of death and/or intracranial haemorrhage for outborn very low birth weight infants was five-fold increased compared to those not transported postnatally. Babies with congenital heart disease comprised the one-fourth of all transports. The long-term mortality was 14% for the whole study population, and 29% for infants with congenital heart disease. Only seven deaths (3.2%) were defined as being transport-related; death during or within 24 h after transport. However, preventable complications like temperature instability, hypoglycaemia and hypo-/hypercapnia occurred in 10-20% of all transports. CONCLUSION: The transport related mortality was low in this study, however very low birth weight infants and infants with major congenital heart disease showed a relatively poor outcome.     

Setting up a neonatal transport service: Air transport

Air transport is an integral part of any system that provides neonatal care in the developed world. To ensure that this is developed in an efficient and appropriate manner a prospective analysis is required to allow a multidisciplinary team to progress a project aimed at providing appropriate staff with adequate training using equipment that has satisfied all regulatory bodies.This article highlights the difficulties in achieving this, reflecting on the way in which established air transport teams have overcome many of the difficulties.The commonalities with land based transport are emphasised along with those issues which are specific to teams providing such a service who aspire to become “air capable”.     

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。     

Safety and governance issues for neonatal transport services

Neonatal transport is a subspecialty within the field of neonatology. Transport services are developing rapidly in the United Kingdom (UK) with network demographics and funding patterns leading to a broad spectrum of service provision.Applying principles of clinical governance and safety to such a diverse landscape of transport services is challenging but finally receiving much needed attention.To understand issues of risk management associated with this branch of retrieval medicine one needs to look at the infrastructure of transport teams, arrangements for governance, risk identification, incident reporting, feedback and learning from experience. One also needs to look at audit processes, training, communication and ways of team working.Adherence to current recommendations for equipment and vehicle design are vital.The national picture for neonatal transport is evolving. This is an excellent time to start benchmarking and sharing best practice with a view to optimising safety and reducing risk.     

珠江三角洲新生儿转运网络工作报告

目的　评价珠江三角洲新生儿转运网络（ｎｅｏｎａｔａｌｔｒａｎｓｐｏｒｔｎｅｔｗｏｒｋ, ＮＴＮ） 十年工作及其效果。方法　介绍新生儿转运网络方法及分析有关效果的资料。结果　转运网络现有８７ 家医院;１０ 年共转运急危重症新生儿８ １２４ 例,转运途中死亡３５ 例,病死率为０．４３％ ;第三级新生儿监护病房（ＮＩＣＵ）收容８ ０８９ 例,共死亡３６４ 例,病死率为４．５０ ％ ,ＮＴＮ 医院中总死亡率为２．０７‰。结论　该ＮＴＮ 所实行的运转机制合理适用;促进了网络单位包括三级ＮＩＣＵ 的发展与提高;建立ＮＴＮ是降低新生儿死亡率的重要措施。     

Evaluating and improving neonatal transport services

Interfacility transport is a necessary part of hospital care. Neonates often need to access specialist input at different sites necessitating a reliable transfer process. Services have evolved significantly over the last ten years to meet this need. This followed the recognition that ad hoc arrangements were unreliable and often unsafe.     

新生儿糖尿病研究进展

新生儿糖尿病是一组异质性单基因遗传病,常被误诊为1型糖尿病.永久性新生儿糖尿病与免疫无关,主要与KCNJ 11、ABCC8和胰岛素基因等基因突变有关;多以酮症酸中毒起病,伴宫内发育迟缓、脱水.基因检测有助于疾病分型,并可根据不同致病基因进行靶向治疗.对于ATP敏感的K+通道基因突变的永久性新生儿糖尿病患儿可口服磺脲类降...     

Sound and vibration: effects on infants' heart rate and heart rate variability during neonatal transport

Aim: To measure the effect of sound and whole‐body vibration on infants’ heart rate and heart rate variability during ground and air ambulance transport. Methods: Sixteen infants were transported by air ambulance with ground ambulance transport to and from the airports. Whole‐body vibration and sound levels were recorded and heart parameters were obtained by ECG signal. Results: Sound and whole‐body vibration levels exceeded the recommended limits. Mean whole‐body vibration and sound levels were 0.19 m/s² and 73 dBA, respectively. Higher whole‐body vibration was associated with a lower heart rate (p < 0.05), and higher sound level was linked to a higher heart rate (p = 0.05). The heart rate variability was significantly higher at the end of the transport than at the beginning (p < 0.01). Poorer physiological status was associated with lower heart rate variability (p < 0.001) and a lower heart rate (p < 0.01). Infants wearing earmuffs had a lower heart rate (p < 0.05). Conclusions: Sound and whole‐body vibration during neonatal transport exceed recommended levels for adults, and sound seem to have a more stressful effect on the infant than vibrations. Infants should wear earmuffs during neonatal transport because of the stress‐reducing effect.     

新生儿坏死性小肠结肠炎遗传多态性研究进展

新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)仍是新生儿期发病率和病死率较高的疾病,其病因目前尚不十分明确.炎症级联反应、先天性免疫及肠道血流动力学改变等在NEC发病机制中有重要作用.单核苷酸多态性是指DNA序列中单个碱基发生的变异,它可能通过改变转录效率或其所编码的分子的结构而与疾病相关联.该文就NEC相关因子如炎症因子、Toll样受体信号通路、甘露糖结合凝集素、血管内皮生长因子、氨甲酰磷酸合成酶、血管紧张素转换酶等的单核苷酸多态性研究作一综述.     

新生儿缺氧缺血性脑病的MRI研究进展

新生儿缺氧缺血性脑病(hypoxia ischemic encephalopathy,HIE)是指由围生期缺氧窒息导致的脑缺氧缺血性损伤.随着MRI技术的不断发展,MRI不仅能反映新生儿HIE的解剖、病理改变,而且能够反映其早期分子水平和代谢水平的变化,进行HIE病变性质与程度评价,并且无放射性损害,是HIE理想的影像检查方法.该文就近年来MRI在HIE诊断、判断预后等方面应用的研究进展作一综述.