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目的 探索新生儿安全转运的方法及新生儿危重病例评分法在新生儿转运中的应用价值。方法 对近两年由重庆医科大学儿童医院双程转运回院的 14 7例新生儿 ,按新生儿危重病例评分方法进行评分 ,分为≥ 90分、80～ 89分、70～ 79分和 <70分四组 ,分析危重儿评分与预后的关系。结果 (1)全部病例均安全转运回NICU。(2 )非危重儿 (≥ 90分 )占 19 0 % (2 8例 ) ,危重儿 (70～ 89分 )占 72 1% (10 6例 ) ,极危重儿 (<70分 )占 8 8% (13例 )。 (3)围生儿占 95 9% (14 1例 )。 (4)转运前低体温 (T <35℃ )占 2 5 9% (38/14 7) ,入院时血pH值 <7 35占82 4 % (112 /136 ) ,血糖异常者占 4 0 1% (5 5 /137)。结论 合理保暖、维持体内环境稳定、保持呼吸道通畅、吸氧等措施在安全转运中显得极其重要 ,是成功转运的关键之一。新生儿危重病例评分法能反映转运新生儿病情危重程度 ,可以作为新生儿转运的指征。
Objective To explore the method of safe transit of newborn and the application value of neonatal critical case score in neonatal transit. Methods A total of 147 newborns who returned to the hospital from ChongQing Medical University Children’s Hospital in recent two years were scored according to the critically ill neonatal case score method and were divided into two groups: ≥90, 80-89, 70-79 and < 70 points, four groups, analysis of the relationship between critical score and prognosis. Results (1) All cases were safely transfered back to NICU. (2) 19 0% (28 cases) of non-critically ill children (≥ 90 points), 72 1% (70 cases) of critically ill children (70-89 points), 8 8 cases of critically ill children (<70 points) % (13 cases). (3) Perinatal children accounted for 95.9% (141 cases). (4) Pre-transfusion hypothermia (T <35 ℃) accounted for 259% (38/14 7), admission blood pH <735 accounted for 82 4% (112/136), blood glucose abnormalities accounted for 4 0 1 % (5 5/137). Conclusions It is one of the keys to successful transit that it is very important to keep warm, maintain the stable environment in the body, keep the airway open and oxygen absorption and other measures in safe transit. Neonatal critically ill case score method can reflect the critical condition of the transport of newborns, can be used as an indicator of neonatal transit.