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目的探索基层推广“新生儿复苏”技术培训的方法。方法 1选取新生儿窒息发生率较高的山区县和川区县各一个作为研究地区,选择经济基础相当的山、川区县各一个作为对照地区;2采取问卷调查和现场调查相结合的方式,对研究地区和对照地区进行调查;3对两个地区县级以上医疗保健机构产儿科、麻醉科医护人员统一进行规范化“新生儿复苏”培训,培训后完成理论和操作考核;4对研究地区采取驻县专家蹲点的形式,定期深入助产机构,对业务人员进行新生儿复苏技术现场培训,对制度的建立进行督导,对照地区无上述措施。结果 1培训后业务人员知识知晓率(t=6.223,P=0.000)及复苏流程操作的掌握程度(t=6.538,P=0.000)与培训前相比明显提高。半年后,研究地区业务人员知识知晓率(t=1.848,P=0.076)及复苏流程操作(t=1.364,P=0.185)保持较好,对照地区业务人员知识知晓率(t=7.41,P=0.000)及复苏流程操作(t=13.82,P=0.000)明显下降,差异均有统计学意义;2研究地区新生儿窒息发生率由2.07%下降至1.48%(χ2=7.41,P=0.006),窒息死亡率由164.43/10万下降至54.63/10万(χ2=4.03,P=0.0447);对照地区上述变化无统计学意义;3研究地区医疗保健机构新生儿复苏设备配备齐全,建立了院内新生儿复苏制度,对照地区部分机构手术室设备不全,尚未建立院内新生儿复苏制度。结论采取驻县专家蹲点的形式,有助于基层人员新生儿复苏技能的提高,促进院内新生儿复苏制度的建立,有利于降低新生儿窒息发生率和窒息死亡率。
Objective To explore ways to promote grassroots technology training in neonatal resuscitation. Method 1 Select mountain and county counties with high incidence of neonatal asphyxia as a research area, select the equivalent economic basis mountain, a county as a control area; 2 to take a combination of questionnaires and on-site surveys To investigate the research area and the control area; 3 To standardize the “Pediatric Neonatal Resuscitation” training for pediatrics and anesthesia nursing staff of the health care institutions at or above the county level in two regions and to complete the theoretical and operational assessment after training; 4 pairs The study area took the form of stay-in-place of experts in the county to conduct regular in-depth midwifery, on-site training of business personnel in neonatal resuscitation technology and supervising the establishment of the system, without the above measures in the control area. Results 1 The awareness rate (t = 6.223, P = 0.000) and operational mastery degree (t = 6.538, P = 0.000) of trainees after training were significantly higher than those before training. Six months later, the awareness rate (t = 1.848, P = 0.076) and operation procedure (t = 1.364, P = 0.185) 0.000) and resuscitation procedure (t = 13.82, P = 0.000), the difference was statistically significant. 2 The incidence of neonatal asphyxia in study area decreased from 2.07% to 1.48% (χ2 = 7.41, P = 0.006) Asphyxia mortality decreased from 164.43 / 100000 to 54.63 / 100000 (χ2 = 4.03, P = 0.0447). There was no significant difference in the control area between the above two groups. (3) The neonatal resuscitation equipment in the medical and health care institutions in the study area was fully equipped, Children’s recovery system, some institutions in the control area operating room equipment is incomplete, the hospital has not yet established a system for the recovery of newborns. Conclusions Adopting the pattern of stay-in-place of experts in the county helps to improve the resuscitation skills of grass-roots personnel and promote the establishment of neonatal resuscitation in the hospital, which will help to reduce neonatal asphyxia and asphyxia mortality.