Ameh Emmanuel A, Ameh Nkeiruka
Paediatric Surgery Unit, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Trop Doct. 2003 Jul;33(3):145-7. doi: 10.1177/004947550303300308.
Advances in neonatal intensive care, total parenteral nutrition and improvements in technology have led to a greatly improved outcome of neonatal surgery in developed countries. In many parts of sub-Saharan Africa, however, neonatal surgery continues to pose wide-ranging challenges. Delivery outside hospital, delayed referral, poor transportation, and lack of appropriate personnel and facilities continue to contribute to increased morbidity and mortality in neonates, particularly under emergency situations. Antenatal supervision and hospital delivery needs to be encouraged in our communities. Adequate attention needs to be paid to providing appropriate facilities for neonatal transport and support and training of appropriate staff for neonatal surgery. Neonates with surgical problems should be adequately resuscitated before referral where necessary but surgery should not be unduly delayed. Major neonatal surgery should as much as possible be performed by those trained to operate on neonates. Appropriate research and international collaboration is necessary to improve neonatal surgical care in the environment.
新生儿重症监护、全胃肠外营养的进展以及技术的改进，已使发达国家新生儿手术的预后得到极大改善。然而，在撒哈拉以南非洲的许多地区，新生儿手术仍面临着诸多挑战。院外分娩、转诊延迟、交通不便以及缺乏合适的人员和设施，继续导致新生儿发病率和死亡率上升，尤其是在紧急情况下。我们的社区需要鼓励产前监护和医院分娩。需要充分重视为新生儿转运提供适当设施，以及为新生儿手术培训合适的工作人员。有手术问题的新生儿在必要转诊前应得到充分复苏，但手术不应过度延迟。重大新生儿手术应尽可能由经过新生儿手术培训的人员进行。开展适当的研究和国际合作对于改善该环境下的新生儿外科护理很有必要。
