Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2018, Vol. 14 ›› Issue (01): 85 -91. doi: 10.3877/cma.j.issn.1673-5250.2018.01.014

Special Issue:

Original Article

Analysis of current situations of neonatal emergency transport system in Yibin City

Li Gu1,(), Wei Huang1, Mukui Wang1, Huaying Su1, Jiemei Yang1   

  1. 1. Department of Neonatology, First People′s Hospital of Yibin, Yibin 644000, Sichuan Province, China
  • Received:2017-11-05 Revised:2018-01-05 Published:2018-02-01
  • Corresponding author: Li Gu
  • About author:
    Corresponding author: Gu Li, Email:
Objective

To explore the current situations of neonatal emergency transport system (NETS) in Yibin, Sichuan Province.

Methods

A total of 1 184 neonates with critical illness transferred into Department of Neonatology, First People′s Hospital of Yibin by NETS from January 2015 to December 2016 were chosen as study subjects. They were divided into two groups according to the year transferred into Department of Neonatology by NETS: 2015 year group (n=645) and 2016 year group (n=539), respectively. The general clinical data, composition of diseases (classified according to the result of first diagnosis at the time of admission), referral hospitals, referral distance and time, strateges of hospitalization treatment, duration of hospital stay, hospitalization expenses, and outcomes of all neonates were retrospectively analyzed. The referral distance and time of two groups were compared by independent samples t test. The durations of oxygen therapy, nasal continuous positive airway pressure (nCPAP) and tracheal cannula mechanical ventilation, duration of hospital stay, hospitalization expenses between two groups were compared by Wilcoxon rank sum test. The constituent ratios of day-age at the time of admission by NETS and referral hospitals, rates of oxygen therapy, nCPAP and tracheal cannula mechanical ventilation between two groups were compared by chi-square test. This study was approved by the Ethics Committee of Human Beings in First People′s Hospital of Yibin and guardians of every subject signed informed consent of clinical research. There were no statistical differences between two groups in constituent ratios of gender, gestational age and birth weight (P>0.05).

Results

①From January 2015 to December 2016, a total of 1 184 neonates with critical illness were transferred into our hospital by NETS, and none of them died during transfer process. ②The ratio of neonates transferred into our hospital by NETS within 24 h after birth in 2016 year group was 81.1% (437/1 184), which was higher than that in 2015 year group 71.2% (459/1 184), and the difference was statistically significant (χ2=15.676, P<0.001). ③The top three diseases of 1 184 neonates with critical illness transferred by NETS in this study were neonatal pneumonia with 632 neonates accounting for 53.4% (632/1 184), neonatal hypoxic-ischemic encephalopathy with 122 neonates accounting for 10.3% (122/1 184), and neonatal hyperbilirubinemia with 91 neonates accounting for 7.7% (91/1 184). ④The 1 184 neonates with critical illness transferred by NETS were transferred from 54 referral hospitals. The referral distance was (45.8±28.4) km, and the duration of referral time was (71.6±43.2) min. There were no significant differences between 2015 year group and 2016 year group in the aspects of constituent ratio of referral hospitals grades, number of transferred neonates from different referral hospitals, referral distance and the duration of referral time (P>0.05). ⑤Among 1 184 neonates with critical illness transferred by NETS in this study, 393 neonates (33.2%, 393/1 184) were given oxygen therapy, 158 neonates 13.3% (158/1 184) were given nCPAP treatment, and 182 neonates 15.4% (182/1 184) were given tracheal cannula mechanical ventilation. There were no statistical differences between two groups in the rates and durations of oxygen therapy, nCPAP and tracheal cannula mechanical ventilation, duration of hospital stay and cost (P>0.05). ⑥Among 1 184 neonates with critical illness transferred by NETS, rate of cured or improved was 93.7% (1 109/1 184), rate of given up treatment was 3.7% (44/1 184), and 37 neonates 2.6% (37/1 184) were transferred to another high grade hospitals. There was no statistical difference between two groups in the constituent ratio of cured or improved, given up treatment, and transferred to another high grade hospitals (P>0.05).

Conclusions

The NETS in our hospital is running well now. It has solved the problems of poor equipment and shortage of technological level in primary hospitals in Yibin and surrounding areas.

表1 采取新生儿急救转运系统转运的1 184例危重新生儿的一般临床资料比较[例数(%)]
表2 2组采取新生儿急救转运系统转运患儿的一般临床资料比较[例数(%)]
图1 2组采取新生儿急救转运系统转运患儿的疾病种类分布条形图
表3 2组采取新生儿急救转运系统转运患儿的转诊医院级别分布及其转诊患儿数、转诊距离及时间比较
表4 2组采取新生儿急救转运系统转运患儿住院治疗情况及住院时间、费用比较
表5 2组采取新生儿急救转运系统转运患儿转归情况比较[例数(%)]
[1]
中国医师协会新生儿专业委员会. 中国新生儿病房分级建设与管理指南(建议案)[J]. 中华实用儿科临床杂志,2013, 28(3):231-237.
[2]
孔祥永,封志纯. 《中国新生儿转运指南》解读[J]. 中华实用儿科临床杂志,2013, 28(2):158-160.
[3]
邵肖梅,叶鸿瑁,丘小汕,主编. 实用新生儿学[M]. 北京:人民卫生出版社,2011: 161.
[4]
封志纯. 高危新生儿的转运[J]. 中国儿童保健杂志,2008, 16(1):5-8.
[5]
陈运彬. 新生儿转运的现状和挑战[J]. 中国新生儿科杂志,2011, 26(1):10-14.
[6]
Mullane D, Byrne H, Clarke TA, et al. Neonatal transportation: the effects of a national neonatal transportation programme[J]. Ir J Med Sci, 2004, 173(2):105-108.
[7]
Kumar PP, Kumar CD, Venkatlakshmi A. Long distance neonatal transport: the need of the hour[J]. Indian Pediatr, 2008, 45(11):920-922.
[8]
高琦,田秀英,郑军,等. 317例新生儿转运分析[J]. 实用临床医学,2014, 15(9):73-75.
[9]
徐巍,穆志红,武辉. 吉林省危重新生儿转运现状分析[J]. 中国妇幼保健,2012, 27(34):5507-5510.
[10]
余玲玲,朱雪萍,肖志辉,等. 区域性危重新生儿主动型院前急救转运的应用及意义[J]. 东南大学学报(医学版), 2014, 33(5):612-615.
[11]
张雪峰,李瑛,肖桂华,等. 区域内危重新生儿转运体系的应用研究[J]. 中国当代儿科杂志,2012, 14(2):101-104.
[12]
薛惠娟. 上海市金山区429例危重新生儿转运结果分析[J]. 上海预防医学,2015, 27(10):633-634.
[13]
余章斌,蒋犁,乔立兴,等. 区域性危重新生儿转运系统建立的意义[J]. 实用儿科临床杂志,2006, 21(6):336-337.
[14]
黄巍,曾巧平. 危重新生儿院前急救与转运网络的实践及效果评价的研究[J]. 中国现代医生,2014, 52(36):22-25.
[15]
国家卫生和计划生育委员会. 危重新生儿救治中心建设与管理指南[J/CD]. 发育医学电子杂志,2018, 6(1):7-14.
[16]
Fairchild K, Sokora D, Scott J, et al. Therapeutic hypothermia on neonatal transport: 4-year experience in a single NICU[J]. J Perinatol, 2010, 30(5):324-329.
[17]
Lutman D, Petros A. Inhaled nitric oxide in neonatal and paediatric transport[J]. Early Hum Dev, 2008, 84(11):725-729.
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