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新しい周産期医療のありかた


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タイトル: 新しい周産期医療のありかた
その他のタイトル: An effective perinatal transport in the future
著者: 久保田, 健二
著者(別表記) : Kubota, Kenji
発行日: 1992年 3月31日
引用: 長崎大学医療技術短期大学部紀要 = Bulletin of the School of Allied Medical Sciences, Nagasaki University. 1992, 5, p.33-39
抄録: 近年の医療技術の目覚ましい進歩の状況下で,且つ健全な児を求める少産少死の社会的needsに応えるためには,産科的知識,技術は基より,人的或いは設備の充分な活用が不可欠で,その為の有効な手段として診療機関の能力に応じた「役割の分担」が考えられる.本論文では地域医療における「役割の分担」の展開の経過を示し,特に「母体搬送」について検討を加え,1)生下時体重2000g未満のものではRDS(呼吸窮迫症候群)の発症率と死亡率に,2)在胎週数34週未満ではRDSの発症率,3)32週未満では死亡率に有意差を認め,4)肺成熟を促すには最少24時間が必要な事を確認し,今後の周産期医療のありかたを示唆した. / Lately, perinatal care has been rapidly developed. On the other hand, in japan, the birthrate has been decreasing recently and therefore it has come a social demand that each deliverly shoud be cared more carefuly. To apply medical progress in perinatal practice, it is necessary to make an effective system of a regional perinatal health care unit. From this point of view, to know wether maternal transport was more effective than neonatal transport, we retrospectively compared perinatal mortality and mobidity between neonates who were born in our hospital (in-born group) and those who were born in other hospitals and were transferred to our neonatal intensive care unit (out-born group). Both perinatal mortality and the incidence of respiratory distress syndrome (RDS) in neonates who weighted less than 2,000g at birth were significantly higher in the out-born group than those in the in-born group. When comparing neonates whose gestational age at birth were before 32 weeks gestation, perinatal mortality rate in the out-born group was significantly higher than that in the inborn group. Before 34 weeks gestation, the incidence of RDS in the out-born group was also significantly higher than that in the in-born group. Aditionaly, the effect of maternal transport on prophylaxis of RDS was found only when deliveries were postponed for 24 hours or more after maternal transport. From these result, we conclude that maternal transport is more effective than neonatal transport to improve both perinatal mortality and mobidity. It is also suggested that the timing of maternal transport is important.
キーワード: 周産期医療 / 母体搬送 / 地域化構想 / 早産 / 未熟児
URI: http://hdl.handle.net/10069/18153
ISSN: 09160841
資料タイプ: Departmental Bulletin Paper
原稿種類: publisher
出現コレクション:第5巻

引用URI : http://hdl.handle.net/10069/18153

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