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[新生儿转运的质量评估]

[Quality evaluation of neonatal transports].

作者信息

Meberg Alf, Hansen Thor Willy Ruud

机构信息

Barnesenteret Sykehuset i Vestfold, 3116 Tønsberg.

出版信息

Tidsskr Nor Laegeforen. 2005 Sep 22;125(18):2474-6.

Abstract

BACKGROUND

Neonatal transports carry risk of complications and technical mishaps which may cause deterioration of the patient's condition.

MATERIAL AND METHODS

Prospective observational study on all transports from the subregional neonatal unit, Vestfold Hospital, Norway to other hospitals during the 23-year period 1982-2004.

RESULTS

396 transports were undertaken with a total of 359 patients, 0.7% of live born infants (n = 49,250). Indications were prematurity/respiratory distress syndrome (RDS) in 84 (21%), congenital malformations in 188 (47%), and other conditions in 124 (31%). After the establishment a local respirator programme 1989, transports for prematurity/RDS declined significantly from the 7-year period 1982 - 88 to the 16-year period 1989-2004 (3.4 vs. 1.0 per 1000 live born infants ;p < 0.0001). Night-time transports declined by 55 %. Technical mishaps occurred in 4% of the transports. No deaths occurred during transport; however, 10 infants (2.8%) died within 24 hours on arrival.

INTERPRETATION

Neonatal transports were associated with risk of deterioration. High local competence and up-to-date technical equipment for neonatal intensive care improve the quality of transport, reduce the incidence of transports of premature infants with RDS, and of transports during night-time.

摘要

背景

新生儿转运存在并发症和技术失误的风险,这可能导致患者病情恶化。

材料与方法

对1982年至2004年这23年间从挪威韦斯特福尔医院的地区性新生儿病房转运至其他医院的所有病例进行前瞻性观察研究。

结果

共进行了396次转运,涉及359名患者,占活产婴儿的0.7%(n = 49,250)。转运指征包括早产/呼吸窘迫综合征(RDS)84例(21%)、先天性畸形188例(47%)、其他情况124例(31%)。1989年建立当地呼吸机项目后,早产/RDS的转运次数从1982 - 1988年的7年期间显著下降至1989 - 2004年的16年期间(每1000例活产婴儿中分别为3.4例和1.0例;p < 0.0001)。夜间转运次数下降了55%。4%的转运发生了技术失误。转运期间无死亡病例;然而,10名婴儿(2.8%)在到达后24小时内死亡。

解读

新生儿转运与病情恶化风险相关。新生儿重症监护的高当地能力和最新技术设备可提高转运质量,降低RDS早产儿的转运发生率以及夜间转运发生率。

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