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目的:分析未愈出院新生儿情况,为有效降低未愈率,提升医疗质量提供依据。方法:回顾性总结对2008年1月~2012年12月在延边大学附属医院儿科NICU住院的新生儿,选出日龄<28天的未愈出院新生儿,疾病未愈而且家属坚决要求并签字出院者为研究对象。记录患儿的基本情况、家庭情况、围产期情况、临床表现、治疗转归、新生儿随访等,并进行统计学分析。结果:新生儿未愈出院率呈逐年增加的趋势,差异有统计学意义(P<0.05);未愈出院新生儿中男、女性别之间比较,差异无统计学意义(P>0.05);未愈出院新生儿中汉族多于朝鲜族,两者比较,差异有统计学意义(P<0.05)。未愈出院新生儿中早产儿(14.52%)所占比例多于足月儿(7.84%),两者比较,差异有统计学意义(P<0.05)。针对各系统疾病及并发症情况分析结果显示,窒息、新生儿呼吸窘迫综合征(NRDS)、呼吸衰竭、电解质紊乱及肺出血发生率早产儿较足月儿高,两者比较,差异有统计学意义(P<0.05)。未愈出院新生儿中先天性畸形所占比例为32.65%。未愈出院患儿经济状况调查显示,月收入<2 000元家庭占88.63%。结论:NICU未愈出院率逐年增加;未愈出院中早产儿比例高,降低早产及其并发症的发生是减少未愈出院率,提高新生儿存活率具有重要意义;未愈出院中先天畸形比例高,加强产前及孕早期的保健,控制新生儿先天畸形的发生,可能降低未愈出院率;治疗费用问题是未愈出院的重要原因之一,建立和完善新生儿保险政策对降低未愈出院率有重要意义。
OBJECTIVE: To analyze the situation of newborn infants who have not been discharged and provide the basis for effectively reducing the unhealed rate and improving the medical quality. Methods: A retrospective summary of January 2008 ~ December 2012 in Yanbian University Hospital Pediatric NICU hospitalized newborns, selected day <28 days of unplanned discharged newborns, the disease did not heal and the family members strongly requested and signed Discharged patients for the study. Record the basic situation of children, family situation, perinatal conditions, clinical manifestations, treatment outcome, neonatal follow-up, and statistical analysis. Results: The rate of unplanned newborn infants showed a trend of increasing year by year with a significant difference (P <0.05). There was no significant difference in male and female neonates after discharged from infants (P> 0.05). There were more Han and Han nationality than the Korean nationality in the neonates discharged from hospital, the difference was statistically significant (P <0.05). The proportion of premature infants (14.52%) who were released from hospitalization was more than that of term infants (7.84%). There was a significant difference between the two groups (P <0.05). According to the analysis of the disease and complications of each system, the results showed that asphyxia, neonatal respiratory distress syndrome (NRDS), respiratory failure, electrolyte imbalance and incidence of pulmonary hemorrhage were higher in preterm infants than in full-term infants, the difference was statistically significant Significance (P <0.05). The proportion of congenital malformations in untreated newborns was 32.65%. Unplanned discharge of children in the economic status survey, monthly income <2 000 yuan households accounted for 88.63%. Conclusion: The rate of unplanned NICU increase year by year; the proportion of premature infants who have been hospitalized out of hospital is high, reducing the incidence of premature birth and its complications is important to reduce the rate of unplanned discharge and improve the survival rate of newborn; rate of congenital malformation High, strengthen prenatal and early pregnancy health, control neonatal congenital malformations, may reduce the rate of unplanned discharge; treatment costs is an important reason for unplanned discharge, establish and improve newborn insurance policies to reduce healed The rate of discharge is of great importance.