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目的:探讨基层医院新生儿复苏管理模式及其在落实新生儿复苏指南中的作用。方法:成立有医疗行政管理人员参加的医院新生儿复苏领导小组,规范新生儿复苏培训,制定复苏人员考核和上岗前资格认可制度。比较佛山市南海区大沥镇所属3所镇级医院加强医院复苏管理前后新生儿复苏的规范操作、复苏用药、窒息发生率及转归情况。结果:加强医院复苏管理前新生儿窒息年发生率为3.48%,加强医院复苏管理后第1年和第2年新生儿窒息年发生率分别为2.34%和2.13%,组间比较P<0.01,差异有统计学意义。加强医院复苏管理前后,规范复苏率分别为57.65%、71.25%和82.53%,逐年增加,组间比较P<0.01,差异有统计学意义。加强医院复苏管理后复苏用药减少,不合理用药和滥用药物情况逐年减少,组间比较P<0.05,差异有统计学意义。结论:在行政干预下规范复苏培训和考核制度的医院复苏管理模式,是落实新生儿复苏指南的重要手段,是基层医院易于操作的提高新生儿复苏质量的有效方法,值得在镇级基层医院推广。
Objective: To explore the management model of neonatal resuscitation in primary hospitals and its role in the implementation of guidelines for neonatal resuscitation. Methods: The hospital led by the medical administrative staff to participate in the establishment of a leading group for neonatal resuscitation, normalization of neonatal resuscitation training, the development of recovery staff assessment and pre-employment qualification system. To compare the standard operation, resuscitation medication, the incidence of asphyxia and the outcome of the resuscitation before and after the hospital resuscitation in 3 township hospitals affiliated to Dali Town, Nanhai District, Foshan City. Results: The annual incidence of neonatal asphyxia before hospital resuscitation management was 3.48%. The annual incidence rates of neonatal asphyxia in the first year and the second year after the hospital resuscitation management were 2.34% and 2.13%, respectively, P <0.01, The difference was statistically significant. Before and after strengthening the hospital resuscitation management, the standard recovery rate was 57.65%, 71.25% and 82.53%, increasing year by year, the comparison between groups P <0.01, the difference was statistically significant. After the hospital resuscitation management was strengthened, the resuscitation medication decreased, irrational medication and drug abuse decreased year by year, with a statistically significant difference between the two groups (P <0.05). Conclusion: The hospital recovery management mode, which regulates the system of resuscitation training and appraisal under the administrative intervention, is an important means to implement the neonatal guidelines for resuscitation. It is also an effective way to improve the quality of resuscitation of newborns in grass-root hospitals. It is worth popularizing at the grass-roots level hospitals .