1A-S4-1

OVERVIEW OF CURRENT NEONATAL EMERGENCY MEDICINE IN CHINA

Wei Kelun, Xue Xingdong

China Medical University, Shenyang, China

During the past 10 years, China neonatal emergency medicine has developed faster than before.

First: the perinatal mortality deceased sharply. In 1990,the perinatal morality was 12% to 14%. From 1997 to 2000, it was decreased to 1.6%~10.9%. All these improvements due to these works: One is more and more NICUs were established and have been improved in many big cities in China such as Beijing, Shenyang, Shanghai, Chongqing et al. The transportation for high-risk neonates to NICU is very popular among different hospitals.

Second: with the development of NICU and the wide use of correct or resuscitation the mortality of neonatal asphyxia also reduced. Now the morbidity of neonatal is 3.61% to 9.07% and mortality is 0.9% to 8.76%. In some big cities the incidence rate is below 1%.

Third: with the widely using of ventilation therapy, the perinatal death rate also decreased from 63.1% (in 80's)to 17.8%(in 90's). The complications of ventilation therapy also decreased at the same time. For example, air leak incidence reduced from 12%-13%(in 1997 to 1998)to 6%-8%(in 1999-2000). Infection rats was 23.5%-46.1% which is still higher than developed countries.

Forth: today many NICUs began to use Pulmonary Surfactant, Nitric Oxicle and High-frequency Ventilation to cure severe neonatal lung diseases. ECMO and liquid ventilation had been studied in animal models.

Recently, it was reported by Beijing Xiehe Hospital that the birth rate of premature increased gradually from 4.15%(in 1989) to 5.995%(in 1997-1999). The mortality of premature is about 51.8% of total infant death rate.

Today, how to take a good care of premature is becoming the main problem in China neonatal emergency medicine field.