基于区域医疗中心的危重症儿童长途多模式转运实践分析-国际护理学研究-CSCIED科技核心评价数据库-手机版

基于区域医疗中心的危重症儿童长途多模式转运实践分析

Long-distance multimodal transport of critically ill children: An analysis of practice based on a national regional children's medical center

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DOI	10.12208/j.ijnr.20260230
刊名	国际护理学研究 International Journal of Nursing Research
年，卷(期)	2026, 8(5)
作者	陈文琼, 春晓, 贺芳, 林艳, 王强,
作者单位	广州医科大学附属妇女儿童医疗中心转运中心广东广州;
摘要	目的探讨不同长途院际转运模式对危重症儿童的支持能力、安全性及效率的影响。方法总结2023年1月至2025年5月完成的1300例长途院际儿童重症转运病例，按转运模式分为四组：单救护车转运（1182例）、救护车-救护车对接转运（92例）、救护车-高铁-救护车转运（21例）、救护车-轮渡-高铁-救护车转运（5例）。对比各组转运成功率、呼吸支持需求、转运距离与耗时、不良事件发生率等指标。结果总转运成功率99.23%（1290/1300），失败10例（均属单救护车组，9例因病情危重终止，1例途中死亡）。76.8%（999/1300）患儿需呼吸支持（常频/高频有创通气、无创通气或吸氧）。不良事件共38例（单救护车组占比100%），包括非计划拔管（4例）、病情急剧变化（4例）、设备故障（2例）、车辆故障（28例）。高铁相关转运（26例）无一失败或不良事件。结论危重症儿童长途转运成功率较高，但需严格评估病情稳定性；单救护车转运是主要模式（90.9%），但车辆故障是主要风险点。多式联运（如高铁转运，n=26）在超长距离（最远2150 km）转运中表现出良好的安全性，但样本量有限，其普适性需进一步验证。优化设备维护与转运质控是降低风险的关键。
Abstract	Objective To investigate the impact of different inter-hospital long-distance transport modes on the support capacity, safety, and efficiency for critically ill children. Methods This study reports a series of 1,300 inter-hospital long-distance transports for pediatric critical care, completed from January 2023 to May 2025. The cases were divided into four groups according to the transport mode: single ambulance transport (1,182 cases), ambulance-to-ambulance transfer (92 cases), ambulance-high-speed rail-ambulance transfer (21 cases), and ambulance-ferry-high-speed rail-ambulance transfer (5 cases). Metrics including transport success rate, requirement for respiratory support, transport distance and duration, and incidence of adverse events were compared among the groups. Results The overall transport success rate was 99.23% (1,290/1,300). All 10 failed transports occurred in the single ambulance group (9 cases where treatment was withdrawn due to critical condition and 1 case of death during transport). Respiratory support (including conventional/high-frequency invasive ventilation, non-invasive ventilation, or oxygen therapy) was required in 76.8% (999/1,300) of the children. A total of 38 adverse events were recorded (all in the single ambulance group), including unplanned extubation (4 cases), sudden clinical deterioration (4 cases), equipment malfunction (2 cases), and vehicle breakdown (28 cases). None of the 26 transports involving high-speed rail experienced failures or adverse events. Conclusion Long-distance transport of critically ill children achieves a high success rate but requires strict assessment of the patient's condition stability. Multimodal transport (e.g., utilizing high-speed rail) demonstrates good safety for ultra-long-distance transfers. Vehicle breakdown remains the primary risk factor, highlighting the need for optimized equipment maintenance and enhanced quality control in transport protocols.
关键词	长途转运；院际转运；危重症儿童；转运模式
KeyWord	Long-distance transport ; Inter-hospital transport; Critically ill children; Transport mode
基金项目
页码	20-25

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[1] 孙朋霞, 李树亚, 华小雪, 等. 急危重症患者院间转运护理质量评价指标的构建
[J]. 中华护理杂志, 2023, 58(15):1831-1837.

[2] Singh K, Ojito J, Sasaki J. Safety of Interhospital ECMO Transport by Low-Volume ECMO Transport Centers
[J]. J Pediatr Intensive Care, 2021,10(2):126-132.

[3] 诸纪华, 刘丽丽, 胡静, 等. 危重症患儿院际安全转运护理专家共识
[J]. 中华急危重症护理杂志, 2024,5(09): 825-829.

[4] Bronnum Nystrup K, Poorisrisak P, Breindahl M, et al. Interhospital Transport of Pediatric Patients in Denmark: A Survey of Current Practice
[J]. Pediatr Emerg Care, 2020, 36(8):389-392.

[5] Curfman A, Groenendyk J, Markham C, et al. Implementation of Telemedicine in Pediatric and Neonatal Transport
[J]. Air Med J, 2020,39(4):271-275.

[6] 张胜南, 左钰, 刘科宇, 等. ECMO患者救护车长途转运的临床分析
[J]. 中国急救复苏与灾害医学杂志, 2022, 17(5):677-680.

[7] 王靖, 刘晓红, 赵喆, 等. 40例危重婴幼儿高速铁路长途转运分析
[J]. 中国小儿急救医学, 2021,28(10):925-927.

[8] 孔祥永, 封志纯, 李秋平, 等. 新生儿转运工作指南(2017版)
[J]. 发育医学电子杂志, 2017,5(04):193-197.

[9] Taylor R M, Price-Douglas W. The S.T.A.B.L.E. Program: postresuscitation/pretransport stabilization care of sick infants
[J]. J Perinat Neonatal Nurs, 2008,22(2):159-165.

[10] Schwebel C, Clec'H C, Magne S, et al. Safety of intrahospital transport in ventilated critically ill patients: a multicenter cohort study*
[J]. Crit Care Med, 2013,41(8): 1919-1928.

[11] Warren J, Fromm R E J, Orr R A, et al. Guidelines for the inter- and intrahospital transport of critically ill patients
[J]. Crit Care Med, 2004,32(1):256-262.

[12] Ramnarayan P. Measuring the performance of an inter-hospital transport service
[J]. Arch Dis Child, 2009,94(6): 414-416.

[13] Ramnarayan P, Thiru K, Parslow R C, et al. Effect of specialist retrieval teams on outcomes in children admitted to paediatric intensive care units in England and Wales: a retrospective cohort study
[J]. Lancet, 2010,376(9742):698-704.

[14] Stroud M H, Trautman M S, Meyer K, et al. Pediatric and neonatal interfacility transport: results from a national consensus conference
[J]. Pediatrics, 2013,132(2):359-366.

[15] Ramnarayan P, Dimitriades K, Freeburn L, et al. Interhospital Transport of Critically Ill Children to PICUs in the United Kingdom and Republic of Ireland: Analysis of an International Dataset
[J]. Pediatr Crit Care Med, 2018,19(6):e300-e311.

[16] Lichtenberger P M, Peer M F, Lindtner R A, et al. Helicopter vs. ground-based transfer for emergency interhospital transportation: A time and cost-efficiency analysis across varying transfer distances
[J]. Injury, 2025,56(7):112359.

[17] 陈娟, 蔡喆燚, 蔡亚宏. 重症监护病房护士对危重症患者转运接近失误事件认知的质性研究
[J]. 中国临床护理, 2025, 17(6): 331-335.

引用本文

陈文琼, 春晓, 贺芳, 林艳, 王强. 基于区域医疗中心的危重症儿童长途多模式转运实践分析 [J]. 国际护理学研究. 2026; 8; (5). 20 - 25.

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