在低收入和中等收入国家遵守围产性窒息或败血症管理指南
Afruna Rahman1, Meghna Ray2, Zachary J Madewell3
1International Centre for Diarrhoeal Disease Research Bangladesh (ICDDRB), Dhaka, Bangladesh.
JAMA network open
|May 16, 2025
概括
在低收入和中等收入国家,对新生儿死于周围窒息和败血症的临床护理指南的遵守程度不够理想. 改善遵守是减少高负担地区可预防的新生儿死亡率的关键.
科学领域:
- 新生儿死亡率 新生儿死亡率
- 全球卫生健康 全球卫生健康
- 临床护理指南 临床护理指南
背景情况:
- 新生儿死亡,主要是由于围产期窒息和败血症,不成比例地影响撒哈拉以南非洲和南亚.
- 大多数新生儿死亡是可以通过高质量的临床护理和遵守既定指南来预防的.
研究的目的:
- 评估遵守世界卫生组织 (WHO) 临床护理指南,以管理围产期窒息和新生儿败血症.
- 为了确定与这些疾病死亡的新生儿遵守指南相关的患者级因素.
主要方法:
- 一项横截面研究分析了2015年12月至2023年10月期间死于围产窒息或新生儿败血症的新生儿 (0-28天) 的医疗记录.
- 从7个低收入和中等收入国家的儿童健康和预防死亡监测 (CHAMPS) 站点收集数据.
- 混合效应多变量后勤回归确定了与符合指导方针的处理相关的因素,例如袋罩 (BVM) 通风.
主要成果:
- 对于围产期窒息的指导方针的遵守率差异很大,从上腺素的12.2%到氧气的85.4%;只有4.4%接受了所有推的治疗.
- 对于新生儿败血症,86.8%的人服用了抗生素,但只有61.0%的人接受了完全推的治疗.
- 准确的临床确定围产期窒息与接受BVM通风的可能性增加有关 (aOR, 2.00).
结论:
- 在研究地区,新生儿死于围产期窒息或新生儿败血症的临床护理指南的遵守率低于最佳.
- 这些发现突显出迫切需要改善遵守新生儿死亡率,以减少新生儿死亡率.
- 加强卫生系统的战略对于支持遵守临床护理指南至关重要.
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