切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2013, Vol. 09 ›› Issue (06) : 773 -776. doi: 10.3877/cma.j.issn.1673-5250.2013.06.013

所属专题: 文献

论著

住院不足24小时出院新生儿的现状分析
易海英1,*,*(), 张丙宏2, 张海燕1, 严彩霞2   
  1. 1. 湖北省孝感市中心医院儿科
    2. 430060 ,武汉大学人民医院儿科
  • 收稿日期:2013-07-08 修回日期:2013-11-02 出版日期:2013-12-01
  • 通信作者: 易海英

Status Analysis of Neonatus in Hospital Less than 24 Hours

Hai-ying YI1(), Bing-hong ZHANG2, Hai-yan ZHANG1, Cai-xia YAN2   

  1. 1. Department of pediatrics, Wuhan University People's Hospital, Wuhan 430060, Hubei Province , China
  • Received:2013-07-08 Revised:2013-11-02 Published:2013-12-01
  • Corresponding author: Hai-ying YI
  • About author:
    (Corresponding author:YI Hai-ying,Email: )
引用本文:

易海英, 张丙宏, 张海燕, 严彩霞. 住院不足24小时出院新生儿的现状分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2013, 09(06): 773-776.

Hai-ying YI, Bing-hong ZHANG, Hai-yan ZHANG, Cai-xia YAN. Status Analysis of Neonatus in Hospital Less than 24 Hours[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2013, 09(06): 773-776.

目的

探讨住院不足24 h出院新生儿的现状,以了解其出院原因。

方法

采用回顾性分析法对2007年1月1日至2011年12月31日于湖北省孝感市中心医院新生儿科住院不足24 h出院的379例新生儿的临床病历资料进行相关统计学分析。本研究遵循的程序符合湖北省孝感市中心医院人体试验委员会所指定的伦理学标准,得到了该委员会批准,分组征得受试对象父母的知情同意,并与之签署临床研究知情同意书。

结果

本组379例新生儿中,①出院原因包括:放弃治疗为122例(32.2%),转院为125例(33.0%),好转出院为94例(24.8%),未愈出院为38例(10.0%)。②本组居前4位的疾病为:呼吸系统疾病占45.9%(174例),早产为占35. 3%(134例),神经系统疾病占18. 5%(70例),出生缺陷占12. 7% (48例)。③自2007至2011年5年间住院不足24 h出院新生儿的出院疾病状况构成比比较,每年住院不足24 h因疾病危重放弃治疗而出院的新生儿呈逐年下降趋势,5年间比较,差异有统计学差异(χ2=6. 115,P = 0.013)。5年间未愈出院的新生儿呈逐年上升趋势。转院、好转及未愈新生儿的出院率比较虽有波动,但差异均无统计学意义(P>0. 05)。④5年间住院不足24 h出院新生儿出院原因比较,因病情无望导致的出院率呈逐年下降趋势,5年间比较,差异有统计学意义(χ2 =6.922,P = 0. 009);误解病情、建议转院、经济困难、不满服务、怀疑医术,5年间比较,差异均无统计学意义(P>0. 05)。

结论

导致住院不足24 h新生儿出院既有医疗本身原因亦有社会因素。增加新生儿科硬件配置及医护人员配置,努力提高医院的医疗技术水平,提高服务质量和改善服务态度,完善社会保障机制,可降低住院不足24 h未愈新生儿的出院率,提高本地区新生儿救治率和人口生存质量。

Objective

To investigated the current status and reasons to discharge of neonatus in hospital less than 24 h.

Methods

From January 2007 to December 2011,a total of 379 neonatus in hospital less than 24 h in Xiaogan Central Hospital,Hubei Province,were retrospective analyzed. Their related clinical data were analyzed by statistical methods. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Xiaogan Central Hospital. Informed consent was obtained from the parents of each participating neonate.

Results

①among 379 neonatus being in hospital less than 24 h, 122 cases(32. 2%)were gave up treatments, 125 cases(33. 0%)were hospital referral,94 cases(24. 8%)were improved and 38 cases(10. 0%) were not cured.② The top four diseases of 379 neonatus being in hospital less than 24 h were respiratory system diseases(45. 9%),preterm infants(35. 3%),birth defects (12. 7%) and infectious diseases(12. 1%).③ Comparison of constituent ratio of disease status among 379 neonatus in hospital less than 24 h from 2007 to 2011,rate of abandon treatment was descend year by year, there had statistically difference(χ2 = 6. 115, P = 0. 013). the incidence rate of not cured was risen year by year, and there had statistically difference(P<0. 05). neonatus in hospital less than 24 h caused by hospital referral, improved were fluctuation,but no descend or rise tendency during this 5 years,and there had no statistically difference(P>0. 05).④ Comparison of constituent ratio of reasons among 379 neonatus in hospital less than 24 h from 2007 to 2011,rate of hopeless was descend year by year (χ2 trend test χ2 = 6. 922, P = 0. 009). neonatus in hospital less than 24 h caused by misunderstanding pathogenetic condition, being suggested hospital referral, financial straits,underfill service and suspect leechcraft in this hospital were no descend or rise tendency during this 5 years, and there had no statistically difference (P>0. 05).

Conclusions

There were various medical and social reason in neonatus being in hospital less than 24 h. We should add hardware configuration and medical personnel to the neonate department, improve the autologous medical level arduous, quality of service and attitudes, consummate social aid mechanism, decreased the hospital discharge rate of the hospitalization less than 24 h, improve the level of the local neonatus medical service and the naonatus remedy skills and the life quality, strengthen the health care consciousness and popular neonatal disease.

表1 本组379例新生儿出院时疾病状况及疾病类型比较[n(%)]
Table 1 Comparison of status and types of diseases among 379 neonatus in hospital less than 24 hours[n(%)]
表2 2007至2011年本组379例新生儿出院疾病状况构成比比较[n(%)]
Table 2 Comparison of constituent ratio of disease status among 379 neonatuses in hospital less than 24 hours from 2007 January to December 2011[n(%)]
表3 2007年至2011年本组379例新生儿出院原因构成比比较[n(%)]
Table 3 Comparison of constituent ratio of reasons to discharge among 379 neonatus in hospital less than 24 hours from 2007 January to December 2011[n(%)]
1
Liang SX, Mai ZG, Qiu Y. To explore the influence of reason, influence and countermeasures of automatic hospital discharge of pediatric patients[J]. Chin Hospital Management, 2005 ,25(8) : 35-36.
2
Spitzer AR, Ellsbury DL. Controversial areas of medication therapy for the neonate[J]. Clin Perinatol,2012 ,39(1) : 1056-1058.
3
Yu VY. Ethical decision-making in newborn infants[J]. Acta Med Port, 1997, 10(2-3): 197-204.
4
Fei XL, Ge MY. Reason analysis and countermeasure of pediatric patients in primary hospitals automatic discharge [J]. Baotou Med J,2012,19(4) :256-258.
5
Lu M, Zhu L, Xia YZ, et al. Survey on the spectrum of disease of newborn be hospitalized in Xiaogan City[J]. J Pharmaceut Sci, 2011,24(6) :688-692.
6
Zhu HP, Xia SE, Song F, et al. Comparative study of neonatal respiratory failure clinical 2005—2010 ward [J]. Public health Prevent Med,2012 ,23(3) : 121-123.
7
Su Pw, Gao LY. Perinatal and neonatal health knowledge, and health education[J]. China Reproduct Health, 2009, 20(2) : 105-106.
8
Zhu LL, Shu GH, Xu X, et al. Coagulation changes of hypoxicischemic encephalopathy and it's clinical significance[J/CD]. Chin J Obstet Gynecol Pediatr:Electron Ed, 2011,7(3) : 244-245.
9
Chen C. Emergency prehospital and transport of newborn [J]. Mod Pract Med,2011,23(6) : 604-605.
10
Wang H, Mu DZ, Xiong Y. Evidence-based medicine study suggestion on high frequency oscillatory ventilation in neonates[J/ CD]. Chin J Obstet Gynecol Pediat: Electron Ed, 2010, 6 (6) : 39-43.
11
Zhao JS, Xue MQ, Liu XY. Research on related problems of giving up treatment of pediatric intensive care room [J]. Med Philosoph,2008,29(8):68-69.
12
Hao B, Zhao GL, Feng Qet al. The feasibility study review of medical and health institutions of neonatal death[J]. Chin J Child Health Care,2011,19(4): 321-323.
13
Wei L, Zhou TF. Interpretation guide on electrocardiogram of neonatus. Chin J Obstet Gynecol Pediatr : Electron Ed, 2009,5 (1): 95-97.
[1] 刘真真, 葛志通, 赵瑞娜, 彭思婷, 董一凡, 王欣, 张睿, 朱庆莉, 李建初, 杨筱. 北京协和医院超声医学科住院医师读片会教学效果研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 809-813.
[2] 王佳佳, 詹韵韵, 姜凡, 孙碧云, 毕玉, 李如冰, 彭梅. Peyton四步教学法在超声住院医师规范化培训颈部淋巴结分区中的应用[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 814-818.
[3] 吴禾禾, 马春亮, 常青, 陈宇, 牛丽娟, 王勇. 超声医学质量控制与住院医师规范化培训相结合的实践探讨[J/OL]. 中华医学超声杂志(电子版), 2024, 21(07): 698-701.
[4] 林荔军, 谢小波. 分层教学联合虚拟仿真教学在骨科规范化培训中的应用[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 682-687.
[5] 张艳兰, 徐琳, 王彩英, 杨洪玲, 庞琳. 56例先天性梅毒新生儿的临床特征及预后[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(03): 163-169.
[6] 王晓璇, 吴靖, 高雅, 杨栋, 刘欢, 曹正国. 牙周病学分阶段多维立体教学体系在住院医师规范化培训中的探索及应用[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(03): 189-194.
[7] 李伟, 宋子健, 邓龙昕, 赖衍成, 卢晓乐, 吉进, 陈锐. 三维重建技术在腹膜后肿瘤临床教学中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(02): 162-167.
[8] 王绅, 王如海, 李春, 杨震, 孙菲琳. 中重型颅脑创伤患者住院时间延长的危险因素分析及预测模型构建[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 146-153.
[9] 白杰, 王唯一, 陈超, 王帆, 肖新如. 神经外科住培医师职业倦怠及影响因素研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 662-670.
[10] 胡云鹤, 周玉焯, 付瑞瑛, 于凡, 李爱东. CHS-DRG付费制度下GB1分组住院费用影响因素分析与管理策略探讨[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 568-574.
[11] 路明, 张碧莹, 邓忠华, 李晓光, 沈宁. 场景式教学法在发热门诊住院医师教学培训中的应用[J/OL]. 中华临床医师杂志(电子版), 2024, 18(04): 388-391.
[12] 侯晓飞, 王玮, 鲁世保. 基于病例汇报的术前讨论模式在退变性脊柱疾病教学中的应用[J/OL]. 中华临床医师杂志(电子版), 2024, 18(03): 295-298.
[13] 朱文静, 寇惠娟, 倪雅娟, 邓捷, 林琳, 胡筱筠. MDT联合CBL-PBL教学模式及形成性评价在心内科住院医师规范化培训中的应用[J/OL]. 中华诊断学电子杂志, 2024, 12(02): 120-124.
[14] 芦乙滨, 李梦蝶, 许明. PDCA(计划、执行、检查和处理)循环教学在内科住院医师重症超声指导血流动力学评估培训中的效果评价[J/OL]. 中华卫生应急电子杂志, 2024, 10(04): 224-228.
[15] 顾双双, 王权鹏, 张秋灵, 邵斌霞, 王军, 李瑾. 基于案例教学的情景模拟联合改良迷你临床演练评估在急诊科住院医师规范化培训中的应用[J/OL]. 中华卫生应急电子杂志, 2024, 10(03): 149-153.
阅读次数
全文


摘要