八个亚洲国家的重症婴儿的伦理决策:国际调查
Yuri Ozawa1, Rinawati Rohsiswatmo2, Rizalya Dewi3
1Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan.
Pediatrics and neonatology
|February 10, 2026
概括
针对重症新生儿维持生命治疗的伦理决定在亚洲NICU之间有很大差异. 这种变化在怀孕22-25周之间出生的极度早产婴儿中尤为明显.
科学领域:
- 新生儿医学 新生儿医学
- 医学伦理 医学伦理
- 全球健康 全球健康
背景情况:
- 对于新生儿重症监护室 (NICU) 的新生儿来说,关于停止或拒绝维持生命治疗的伦理决策至关重要.
- 关于亚洲国家这些做法的现有数据有限,需要进一步调查区域差异.
- 这项研究通过评估亚洲多个国家的道德决策实践来解决这一差距.
研究的目的:
- 调查和比较各种亚洲国家的新生儿重症监护病房 (NICU) 中维持生命治疗的取消和扣留实践.
- 为了识别可存活的极度早产婴儿与不良预后的伦理决策的变化.
- 提供数据,可以为指导方针提供信息,并改善亚洲脆弱新生儿的护理.
主要方法:
- 在亚洲八个国家的408个NICU的代表中分发了一份基于网络的问卷调查.
- 该调查包括五个问题,评估为特定新生儿预后不佳的情况提供维持生命治疗的频率.
- 回答被分类使用五分级从"经常"到"从来没有",结果被总结为百分比.
主要成果:
- 在接受调查的亚洲国家,应答率为76% (310/408个NICU).
- 对于双边心室内出血的维持生命治疗的停止观察到显著的变化 (0%-100%的设施).
- 与其他国家相比,在怀孕22周出生的婴儿的活体复苏率在日本 (44%) 和韩国 (33%) 高于其他国家 (0-20%). 怀孕23-25周的实践也显示了广泛的范围 (分别为0-85%,9-100%,28-100%).
- 大多数设施 (≥60%) 常规为26周或更长的妊娠期或出生体重为600克或更高的婴儿提供活体复苏.
结论:
- 关于新生儿护理的伦理决定,特别是对于极度早产婴儿 (怀孕22-25周),在亚洲国家之间表现出相当大的差异.
- 这些发现凸显了需要进一步研究和潜在的区域具体指导方针的发展,以管理重症新生儿.
- 了解这些差异对于促进亚洲新生儿重症监护室所有婴儿的公平和道德健全护理至关重要.
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