日本農村医学会雑誌
Online ISSN : 1349-7421
Print ISSN : 0468-2513
ISSN-L : 0468-2513
農村病院における新生児医療の改善についての考察
大山 碩也平石 友三橋 将人末武 教行大西 えり子斉藤 勢津子神辺 譲山田 貞一佐口 美代子
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1980 年 29 巻 4 号 p. 667-671

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We have established NICU (Neonatal Intensive Care Unit) in our hospital and have made efforts to improve the contents of medical treatment since 1976 in order to establish a regionalization of neonatal medical treatment.
Thus are main items of the improvement:
1. Completed the apparatuses and equipments needed in Intensive Care.
2. Promoted the communication with regional facilities of delivery so as to enable immature or stressed mature babies to be transported to our hospital at all hours.
3. Made Pediatrician attend all the deliveries with high risk factors and treat the asphyxiated newborn right after the delivery.
We have recorded the results of comparison of the death rate of immature babies at different birth weight treated in our hospital, and of the perinatal mortality in our Obstetric Department in the pie-improvement period of 5 years (1971-1975) and in the post-improvement period of 4 years (1976-1979) respectively.
The results are as follows:
1. A comparison of the death rate of immature babies at different birth weight.
In comparison of pre and post improvement, under 1, 000 g we haven't had enough cases to compare, besides most of the babies have died. However, at the weight between 1, 001-1, 500 g, the death rate has decreased from 39.4% down to 14.3%, at between 1, 501-2, 000g it has decreased from 11.4% down to 8.9%, and at between 2, 001-2, 500 g, from 6.9% to 1.1%.
2. A comparison of the perinatal mortality in our Obstetric Department.
The perinatal mortality has decreased from 18.5% down to 11.8% when we compare pre and post improvement. This result of the decrease depends on the decrease of fetal death at delivery and baby's death in the early neonatal period. Items of the causes of early neonatal death reveals that the deaths of immature babies and asphyxiated mature babies have decreased significantly.
From these results, we are fully realized the benefit of the regionalization of the neonatal medical treatment and I think we ought to promote such regionalization especially in rural area.

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