目的：对浙江省三级和二级医院新生儿窒息复苏及人员培训情况进行基线调查。方法采用分层随机抽样法在浙江省11个地级市中每个地级市以抽签法抽取5所医院参与调查，其中地级市医院2所，县级医院3所。自制调查问卷，内容包括新生儿复苏开展情况，人员培训，产房、手术室复苏设备情况，新生儿出生窒息发生和死亡情况。结果10/11个地级市49家医院纳入分析，其中三级医院23家（46.9％），二级医院26家。①49家医院均有开展新生儿窒息复苏抢救的能力，三级医院均定期举办新生儿复苏培训。三级医院 NICU 病房配备率高于二级医院（87.0％ vs 34.6％，P =0.0018）。②必备设备的配备：三级和二级医院产房和手术室在新生儿复苏气囊、辐射保温台、喉镜、气管导管和新生儿面罩的配备率均超过90％。高级设备的配备：三级医院产房和手术室血氧饱和仪配备率较高（72.7％），脐静脉导管、喉管、T组合复苏器和空氧混合器的配备率均低于50％。③无论是三级还是二级医院，儿科医生院内和院外培训率均最高，麻醉师培训率最低。除儿科医生外的其他各类接产人员院内和院外培训率在三级和二级医院间差异均有统计学意义（P均＜0.05）。④2004至2010年的年活产数在三级和二级医院中均呈逐年增加趋势。三级和二级医院新生儿年死亡率和出生窒息病死率均呈下降趋势，但总体上三级医院高于二级医院。二级医院重度窒息占出生窒息的比例总体上高于三级医院。结论需加强各类接产人员复苏培训，提高复苏人员的复苏技能及理论水平，购置必备的复苏设备，进一步改善各级医院现有的复苏条件。%Objective To evaluate the situation about carrying out neonatal resuscitation,equipments,personnel training in medical institutions and situations about newborn asphyxia and death in Zhejiang Province. Methods Five health care institutions (2 city-level and 3 county-level)were randomly selected from each city in total 11 cities. Questionnaire surveys were performed about carrying out neonatal resuscitations practice,personnel training and delivery room,operating room resuscitation equipments, situations about newborn asphyxia and death. Results In total of 49 hospitals from 10 cities were included in the survey. All of 49 (100%)hospitals had the ability to carry out neonatal resuscitation. Neonatologist or pediatrician would be the key personnel to resuscitate high-risk newborns in tertiary and secondary hospitals;89. 8% healthcare institutions would at least have one personnel trained for neonatal resuscitation at birth;the number of NICU in tertiary hospitals was more than that in secondary hospitals (87.0% vs34.6%,P =0.002),98.0% healthcare institutions would regularly deliver(or participant)neonatal resuscitation training. 79. 6% healthcare institutions would use training aids. Various confinements personnel training rate was above the county level but below hospital training rate(P<0. 001);Above the county level training pediatricians had the highest rate(P<0. 05). Delivery room neonatal resuscitation units equipped with airbags and radiation heat rate was 100%,laryngeal mask airway was with the lowest rate;theater masks newborn,neonatal resuscitation bag,laryngoscope,suction tube,endotracheal tube with a rate lower than the delivery room. Live birth per year showed a trend of increase year by year in tertiary and secondary hospitals from 2004 to 2010. Neonatal mortality rates and incidence of birth asphyxia declined in tertiary and secondary hospitals,and higher in tertiary. Severe asphyxia rate in secondary hospital was generally higher than that in tertiary hospital. Conclusion It's essential to establish regular and systematic training system,to enhance local medical personnel recovery skills and theoretical level,to purchase the necessary resuscitation equipments,and to improve neonatal resuscitation conditions for all level hospitals.
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