CAJ | 학술논문

目的探讨我院住院不足24 h放弃治疗出院新生儿的相关因素,提高本地区新生儿救治技术和人口生存质量.方法对2007年至2011年住院不足24h的379例新生儿的临床资料进行回顾性分析,对24 h内放弃治疗出院的122例新生儿及住院大于24 h的244例新生儿的相关因素进行单因素及多因素回归分析.结果 (1) 2007年至2011年住院不足24h新生儿共379例,放弃治疗组122例.放弃、转院、好转和未愈四组的胎龄和体重比较差异均有统计学意义(P＜0.01).(2) 2007年至2011年住院不足24h放弃治疗出院新生儿呈逐年下降趋势(卡方趋势检验x2=6.115,P=0.013),未愈组呈逐年上升趋势(P＜0.05),转院组与好转组无逐年上升或下降趋势(P＞0.05).(3) 24 h内放弃治疗组与住院大于24h组比较,在胎龄、出生体重、剖宫产、产时窒息、宫内窘迫、出生医院、家庭年收入＜2万元、父亲文化程度高中及以下、诊断早产儿、极低体重儿、低体重儿、呼吸窘迫综合征、脑损伤等方面差异有统计学意义(P＜0.05).男性、产时高危因素、母亲疾病状态、母亲既往流产史差异无统计学意义(P＞0.05).(4)剖宫产、宫内窘迫、出生于县级医院及以下级别医院、家庭年收入＜2万元、诊断为呼吸窘迫综合征,与24h内放弃治疗出院有相关性,且均为危险因素.其他因素与24h放弃治疗出院无相关性.结论建立系统的产检制度,尽量避免早产,减少呼吸窘迫综合征的发生.增加新生儿科的硬件配置及医护人员的配置,提高专业技术水平,完善社会保障机制,减少住院不足24 h放弃治疗出院新生儿,提高本地区新生儿救治技术和人口生存质量.
목적 탐토아원주원불족24 h방기치료출원신생인적상관인소,제고본지구신생인구치기술화인구생존질량.방법 대2007년지2011년주원불족24h적379례신생인적림상자료진행회고성분석,대24 h내방기치료출원적122례신생인급주원대우24 h적244례신생인적상관인소진행단인소급다인소회귀분석.결과 (1) 2007년지2011년주원불족24h신생인공379례,방기치료조122례.방기、전원、호전화미유사조적태령화체중비교차이균유통계학의의(P＜0.01).(2) 2007년지2011년주원불족24h방기치료출원신생인정축년하강추세(잡방추세검험x2=6.115,P=0.013),미유조정축년상승추세(P＜0.05),전원조여호전조무축년상승혹하강추세(P＞0.05).(3) 24 h내방기치료조여주원대우24h조비교,재태령、출생체중、부궁산、산시질식、궁내군박、출생의원、가정년수입＜2만원、부친문화정도고중급이하、진단조산인、겁저체중인、저체중인、호흡군박종합정、뇌손상등방면차이유통계학의의(P＜0.05).남성、산시고위인소、모친질병상태、모친기왕유산사차이무통계학의의(P＞0.05).(4)부궁산、궁내군박、출생우현급의원급이하급별의원、가정년수입＜2만원、진단위호흡군박종합정,여24h내방기치료출원유상관성,차균위위험인소.기타인소여24h방기치료출원무상관성.결론 건립계통적산검제도,진량피면조산,감소호흡군박종합정적발생.증가신생인과적경건배치급의호인원적배치,제고전업기술수평,완선사회보장궤제,감소주원불족24 h방기치료출원신생인,제고본지구신생인구치기술화인구생존질량.
Objective To investigate the relative factors of the neonates that were abandoned in hospital less than 24 hours,then the level of the local neonates medical service and the neonatal remedy skills and the life quality could be improved.Methods The clinical data of 379 cases of hospitalized neonates less than 24 hours from 2007 to 2011 were analyzed retrospectively.The correlation factors of the neonates abandoned in hospital less than 24 hours(122 cases) and hospitalized more than 24 hours (244 cases) were analyzed by single and multiple factor regression analysis.Results (1) There were 379 neonates who were in hospital less than 24 hours,among them,122 neonates were gave up the treatments.The differences of the gestational age and weight among abandon group,hospital referral group,improve group and uncured group were significant(P ＜0.01).(2) The numbers of neonates abandoned in hospital less than 24 hours were different significantly from 2007 to 2011 (P ＜0.05) and tendency was decreased year by year(chi-square trend test x2 =6.115,P =0.013).The uncured group was increased year by year (P ＜ 0.05).The hospital referral group,improved group were fluctuation,but no descend or rise tendency(P ＞0.05).(3) The differences of the gestational age,birth weight,uterine-incision delivery,intrapartum asphyxia,intrauterine distress,birth hospital,family income less than twenty thousand yuan every year,father's culture level,diagnosed premature,very low birth weight infant,low birth weight infant,respiratory distress syndrome and brain injuries were significant between neonates in hospital less than 24 hours and more than 24 hours(P ＜ 0.05).The differences of the male,intrapartum high risk factors,mother's morbid state and miscarriage were not significant(P ＞0.05).(4) The uterine-incision delivery,intrapartum asphyxia,birth in the county and below county hospital,family income less than twenty thousand yuan every year and diagnosed respiratory distress syndrome were correlation to the abandon treatment in 24 hours.There were no correlation to the gave up treatment in 24 hours to the rest of the factors.Conclusion We should set up the systemic gravid detection system,avoid premature birth and respiratory distress syndrome,add the hardware configuration and medical personnel to the neonate department,improve the professional technology level,perfect social security system mechanism,decrease the hospital discharge rate of the hospitalization less than 24 hours,improve the level of the local neonatal treatment technology and the quality of population.