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。
关键词： 长途转运；院际转运；危重症儿童；转运模式
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 All 10 failed transports occurred in the single ambulance group (9 cases where treatment was withdrawn due to critical condition and 1 case of death during transport).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.
Key words： Long-distance transport ; Inter-hospital transport; Critically ill children; Transport mode
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