Norouzi, Shahram

Simorgh Research Repository

     ﭘﺎﻳﺎن ﻧﺎﻣﻪ  ﻓﻮق ﺗﺨﺼﺼﻲ ﻧﻮزادانﺟﻬﺖ درﻳﺎﻓﺖ درﺟﻪ   ﻋﻨﻮانﻧﻮزادان  ﻣﺮاﻗﺒﺖ وﻳﮋه ﻫﺎي دان ﺑﺴﺘﺮي در ﺑﺨﺶﺗﻌﻴﻴﻦ ﻓﺮاواﻧﻲ ﻣﺮگ و ﻣﻴﺮ ﻧﻮزاﺗﺎ  6931ﻣﺮﻛﺰ آﻣﻮزﺷﻲ ، درﻣﺎﻧﻲ اﻓﻀﻠﻲ ﭘﻮر ﻛﺮﻣﺎن از اﺑﺘﺪاي اردﻳﺒﻬﺸﺖ ﻣﺎه   6931ﭘﺎﻳﺎن ﻣﻬﺮﻣﺎه   اﺳﺘﺎد راﻫﻨﻤﺎ  دﻛﺘﺮ ﭘﺪرام ﻧﻴﻚ ﻧﻔﺲﺟﻨﺎب آﻗﺎي   ﭘﮋوﻫﺶ و ﻧﮕﺎرش  دﺳﺘﻴﺎر ﻓﻮق ﺗﺨﺼﺼﻲ ﻧﻮزادان دﻛﺘﺮ ﺷﻬﺮام ﻧﻮروزي  7931ﺑﻬﺎر  دانشگاه علوم پزشکی  و خدمات بھداشتی درمانی استان کرمان دانشکده پزشکی  ﭼﻜﻴﺪه:ﺷﺎﺧﺺ ﻫﺎي ﻣﻬﻢ ﺗﻮﺳﻌﻪ ﺑﻬﺪاﺷﺘﻲ ﻣﺤﺴﻮب ﻣـﻲ ﺷـﻮد و ﺑـﻲ ﺗﺮدﻳـﺪ ﻣﻴﺰان ﻣﺮگ وﻣﻴﺮ ﻧﻮزادان از  زﻣﻴﻨﻪ و ﻫﺪف:اوﻟﻴﻦ ﻗﺪم در راه ﻛﺎﻫﺶ ﻣﻴﺰان ﻣﺮگ و ﻣﻴﺮ و ارﺗﻘﺎء ﺳﻄﺢ اﻳﻦ ﺷﺎﺧﺺ ، ﺷﻨﺎﺳﺎﻳﻲ ﻋﻠﻞ ﻣﺮگ و ﻣﻴﺮ آن ﻣـﻲ ﺑﺎﺷـﺪ. در اﻳﻦ ﻣﻄﺎﻟﻌﻪ ، ﻓﺮاواﻧﻲ ﻣﺮگ و ﻣﻴﺮﻧﻮزادان ﺑﺴﺘﺮي در ﺑﺨﺶ ﻫﺎي ﻣﺮاﻗﺒﺖ ﻫﺎي وﻳـﮋه ﻧـﻮزادان ﻣﺮﻛـﺰ آﻣﻮزﺷـﻲ ، )ﺑﻪ ﻣﺪت ﺷﺶ ﻣـﺎه( ﻣـﻮرد  6931ﺗﺎ ﭘﺎﻳﺎن ﻣﻬﺮﻣﺎه  6931ﭘﻮر ﻛﺮﻣﺎن و ﻋﻠﻞ آن از اﺑﺘﺪاي اردﻳﺒﻬﺸﺖ درﻣﺎﻧﻲ اﻓﻀﻠﻲ   ﺑﺮرﺳﻲ ﻗﺮار ﮔﺮﻓﺖ.ﻣﻮرد ﻣﻄﺎﻟﻌﻪ ﺷﺎﻣﻞ ﺗﻤﺎﻣﻲ ﻧﻮزادان ﻓـﻮت ﺟﻤﻌﻴﺖ ﺗﻮﺻﻴﻔﻲ ﺑﻮده و  –اﻳﻦ ﭘﮋوﻫﺶ ﻳﻚ ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﻲ  روش ﻛﺎر:ﺮﻣـﺎن از اﺑﺘـﺪاي اردﻳﺒﻬﺸـﺖ ﻣـﺎه ﺳـﺎل ﻣﺮاﻗﺒﺖ وﻳﮋه ﻧﻮزادان ﺑﻴﻤﺎرﺳﺘﺎن اﻓﻀﻠﻲ ﭘﻮر ﻛﻫﺎي ﺷﺪه ﺑﺴﺘﺮي در ﺑﺨﺶ   ﺑﻮد. 6931ﺗﺎ ﭘﺎﻳﺎن ﻣﻬﺮ ﻣﺎه ﺳﺎل  6931زاﻳﻤﺎن ﺷﺎﻣﻞ وﺿﻌﻴﺖ ﺑﺎرداري ﻣﺎدر ، ﻧﻮع زاﻳﻤﺎن و ﻋﺎﻣﻞ زاﻳﻤﺎن ، وﺿـﻌﻴﺖ دﻣﻮﮔﺮاﻓﻴـﻚ  ﭘﻴﺮاﻣﻮنﻋﻮاﻣﻞ ﻣﺨﺘﻠﻒ ﻧﻮزاد در ﺑﺪو ﺗﻮﻟﺪ، ﺷﺮاﻳﻂ اﻧﺘﻘﺎل ﻧﻮزاد از اﺗﺎق زاﻳﻤﺎن / ﻋﻤﻞ ﻳﺎ از ﺑﻴﻤﺎرﺳﺘﺎن دﻳﮕﺮ ﻳﺎ ﻣﻨﺰل ﺑﻪ ﺑﺨﺶ ﻣﺮاﻗﺒﺖ وﻳﮋه ﻞ ﺗﻬﻴـﻪ ﺷـﺪه اﺳـﺖ، ﺗﻜﻤﻴـﻞ ﻛﻪ از ﻗﺒ ـﻓﺮم ﺛﺒﺖ داده ﻫﺎ ﻧﻮزادان ،ﻋﻠﺖ ﺑﺴﺘﺮي و ﻋﻠﺖ اﺻﻠﻲ ﻓﻮت ﻧﻮزاد از ﻃﺮﻳﻖ ﻣﻮرد ﺗﺠﺰﻳﻪ   32  SPSSاﻃﻼﻋﺎت ﺟﻤﻊ آوري ﺷﺪه ﺗﻮﺳﻂ ﭘﺮﺳﺸﻨﺎﻣﻪ ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰار آﻣﺎري  ه ﺳﭙﺲ،ﺪﻳﮔﺮد  و ﺗﺤﻠﻴﻞ ﻗﺮار ﮔﺮﻓﺖ.  %( ﻓﻮت ﻧﻤﻮدﻧﺪ.  31/3ﻧﻔﺮ)211ﻣﺮاﻗﺒﺖ وﻳﮋه ﻧﻮزادان ﺗﻌﺪاد ﻫﺎي ﻧﻮزاد ﺑﺴﺘﺮي در ﺑﺨﺶ  148از ﻣﺠﻤﻮع :ﻳﺎﻓﺘﻪ ﻫﺎ   % ﭘﺴﺮ ﺑﻮدﻧﺪ.  25/7ﻓﻮت ﺷﺪه دﺧﺘﺮ و از ﻧﻮزادان  % 74/3  ﻋﻠﻞ ﺑﺴﺘﺮي ﻧﻮزادان ﻓﻮت ﺷﺪه ﺑﺘﺮﺗﻴﺐ ﺷﺎﻣﻞ:ﻧﺎﻫﻨﺠـﺎري %(،  9/8%(، ﺑﻴﻤـﺎري ﻣـﺎدرزادي ﻗﻠﺒـﻲ )  01/7( ،آﺳﻔﻴﻜﺴﻲ )85)%  )SDR( ﺳﻨﺪرم دﻳﺴﺘﺮس ﺗﻨﻔﺴﻲﺳـﻨﺪرم آﺳﭙﻴﺮاﺳـﻴﻮن %(، 4/5) (WBLوزن ﭘـﺎﻳﻴﻦ ﺑـﺪو ﺗﻮﻟـﺪ ) %(، 4/5%(،ﻣﺸـﻜﻼت ﺟﺮاﺣـﻲ )  8/9ﻣﺎدرزادي )  %(. 1/8%(و ﻫﻴﺪروﭘﺲ ﻓﺘﺎﻟﻴﺲ ) 1/8)(SAMﻣﻜﻮﻧﻴﻮم)ﻧﻔـﺮ(در  5% ﻧـﻮزادان)  4/5از ﻧﻈﺮ ﻣﺪت زﻣﺎن ﺑﺴﺘﺮي در ﻧﻮزادان ﻓﻮت ﺷـﺪه)از زﻣـﺎن ﺑﺴـﺘﺮي ﺗـﺎ ﻓـﻮت ﻧـﻮزاد(،  82%) 52روز اول و  7ﺳـﺎﻋﺖ ﺗـﺎ  27ﻧﻔﺮ(در  14%) 63/6ﺳﺎﻋﺖ اول، 42-27ﻧﻔﺮ(در  83%) 33/9ﺳﺎﻋﺖ اول،42  ده اﻧﺪ.ﻧﻔﺮ(ﺑﻌﺪ از روز ﻫﻔﺘﻢ ﻓﻮت ﻧﻤﻮ 43-73%(، 85)ﻧﻮزاد 56 ﻫﻔﺘﻪ 82-43%(، 41/3)ﻧﻮزاد 61 ﻫﻔﺘﻪ82ﻛﻤﺘﺮاز ،از ﻧﻈﺮ ﺳﻦ ﺑﺎرداري ﻧﻮزادان ﻓﻮت ﺷﺪه   ﺑﻮد. %( 71)ﻧﻮزاد 91 ﻫﻔﺘﻪ 73%(،ﺑﻴﺸﺘﺮ از  01/7)ﻧﻮزاد 21 ﻫﻔﺘﻪ 14 ﮔـﺮم 0001-9941%(، 12/4)ﻧـﻮزاد 42 ﮔـﺮم 0001ﻛﻤﺘـﺮاز ،از ﻧﻈـﺮ وزن ﺑـﺪو ﺗﻮﻟـﺪ ﻧـﻮزادان ﻓـﻮت ﺷـﺪه  2 ﮔﺮم 0004% (و ﺑﻴﺸﺘﺮ از  51/2)ﻧﻮزاد 71 ﮔﺮم 0052-0004%(، 52)ﻧﻮزاد 82 ﮔﺮم 0051-9942%(، 63/6)ﻧﻮزاد  %( ﺑﻮد. 1/8)ﻧﻮزادﻲ ﺑﺎﺷـﺪ ﻣﻞ ﺗﻌﻴﻴﻦ ﻛﻨﻨﺪه ﻣﺮگ و ﻣﻴﺮ ﻧﻮزادي ﻣﻧﺎرﺳﻲ و وزن ﻛﻢ زﻣﺎن ﺗﻮﻟﺪ ﺛﺎﺑﺖ ﺗﺮﻳﻦ و ﻣﻬﻤﺘﺮﻳﻦ ﻋﺎﻧﺘﻴﺠﻪ ﮔﻴﺮي:  ﺑﻮد. SDRو ﺷﺎﻳﻌﺘﺮﻳﻦ ﻋﻠﺖ ﻣﺮگ وﻣﻴﺮ ﻧﻮزادان،  ،آﺳﻔﻴﻜﺴﻲ. وزن ﭘﺎﻳﻴﻦ ﺑﺪو ﺗﻮﻟﺪ، ﺳﻨﺪرم دﻳﺴﺘﺮس ﺗﻨﻔﺴﻲﻧﻮزادان،ﻣﺮگ وﻣﻴﺮ،ﻧﺎرﺳﻲ،ﻛﻠﻤﺎت ﻛﻠﻴﺪي :                               Determination of the frequency of infant mortality in the neonatal intensive care unit of Afzalipour Kerman Medical Education Center from May - October 2017   Abstract: Background: Neonatal mortality rate is one of the most important indicators of health development. Undoubtedly, the first step in decreasing mortality rate and raising the level of this indicator is to identify the causes of its mortality. Therefore, in this study, the frequency of death and morbidity in neonatal intensive care units (NICU) in the Afzalipour Educational Center of Kerman and its causes from the beginning of May - October 2017 (for six months) was investigated. Methods: This is a descriptive cross-sectional study. The study population included all infants of the dead who were admitted to the neonatal intensive care unit of Afzalipour Kerman Hospital from the beginning of May - October 2017. The various factors around Maternal delivery includes maternal pregnancy status, type of delivery and delivery factor, the demographic status of the baby at birth, the condition of delivery from the delivery room / surgery, or from another hospital or home to the infant's care unit, the cause of admission and the main cause of the neonate's death through a questionnaire.. Data collected by questionnaire were analyzed using SSPS-23 software. Results: Of the 841 newborns admitted to the infant's intensive care unit, 112 (13,3%) died of infants. Of the dead infants, 47,3% were female and 52,7% were male. The causes of hospitalization of the infants were as follows: RDS (58%), asphyxia (10,7%), congenital heart disease (9,8%), congenital anomalies (8,9%), surgical problems (4,5%), LBW (4,5%), MAS (1,8%), and hydrops fetalis (1,8%). In terms of hospitalization time, neonates died from incubation until death including: under 24 hours (4,5%) , 24-72 hours (33,9%), 72 hours to 7 days (36,6%), over 7 days (25%). In terms of gestational age, the infants died in the department are below: 28 weeks (14,3%), 28-34 weeks (58%), 34-37 weeks (10,7%), more than 37 weeks (17%). The birth weight of dead babies is less than 1000 grams (21,4%), 1000-1499 grams (6/36%), 1500-2499 grams (25%), 2500-4000 grams (15,2%) and more than 4000 grams (1,8%). Conclusion: Prematurity and low birth weight are the most stable and important determinant of neonatal mortality and the most common cause of infant mortality was RDS. Keywords: Infants, Death, Premature, RDS, LBW, MAS, Asphyxia, Congenital heart disease, Congenital anomalies, Surgical problems ,Hydrops fetalis.    

تعیین فراوانی مرگ و میر نوزادان بستری در بخش های مراقبت ویژه نوزادان مرکز آموزشی ، درمانی افضلی پور کرمان از ابتدای اردیبهشت ماه 1396 تا پایان مهرماه 1396

http://eprints.kmu.ac.ir/29480/1/6877.pdf

تعیین فراوانی مرگ و میر نوزادان بستری در بخش های مراقبت ویژه نوزادان مرکز آموزشی ، درمانی افضلی پور کرمان از ابتدای اردیبهشت ماه 1396 تا پایان مهرماه 1396

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