中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2014年
4期
244-248
,共5页
婴儿,极低出生体重%保温箱,婴儿%低温
嬰兒,極低齣生體重%保溫箱,嬰兒%低溫
영인,겁저출생체중%보온상,영인%저온
Infant,very low birth weight%Incubators,infant%Hypothermia
目的 探讨产房内采用塑料薄膜包裹预防极低出生体重儿(very low birth weight infant,VLBWI)和超低出生体重儿(extremely low birth weight infant,ELBWI)发生低体温的作用.方法 将2009年6月1日至2010年12月1日在温州医科大学附属第二医院(育英儿童医院)产科出生并立即收住新生儿科的早产儿(出生体重＜1 500 g且出生胎龄＜33周)209例,随机分为包裹组105例和未包裹组104例.包裹组用塑料薄膜包裹其躯干及四肢(头面部不包裹,留出脐带,松紧以不妨碍肢体活动为准),并戴上帽子;若有新生儿窒息复苏或其他操作,则迅速包裹塑料薄膜,以不妨碍操作为宜.未包裹组只戴帽子,不用塑料薄膜包裹.观察2组患儿转入新生儿科时的体温、血糖、1h内动脉血气分析以及病死率等情况.采用t检验或x2检验对2组数据进行比较. 结果 包裹组早产儿平均入院体温为(36.1±0.8)℃,高于未包裹组早产儿平均入院体温[(35.5±1.0)℃,t=4.707,P＜0.01];包裹组入院低体温的发生率为41.0％(43/105),低于未包裹组[66.3％(69/104),x2=13.547,P＜0.01];胎龄＜29周的VLBWI中,包裹组平均入院体温为(36.1±0.8)℃,高于未包裹组的(35.4±1.1)℃,差异有统计学意义(t=3.051,P＜0.01);胎龄≥29周的VLBWI中,包裹组平均入院体温为(36.0±0.9)℃,高于未包裹组的(35.5±0.9)℃,差异有统计学意义(t=3.698,P＜0.01).包裹组与未包裹组动脉血气分析的碱剩余值分别为-(2.9±2.7) mmol/L和-(5.0±4.2)mmol/L,差异有统计学意义(t=4.473,P＜0.01).包裹组早产儿入院后气管插管率为20.0％(21/105),未包裹组为27.9％(29/104),差异无统计学意义(x2=1.785,P=0.182);包裹组与未包裹组病死率分别为7.0％(7/100)和11.1％ (11/99),差异无统计学意义(x2=1.023,P=0.312);包裹组出院患儿住院时间为(49.2±10.7)d,未包裹组为(45.8±9.1)d,差异亦无统计学意义(t=1.152,P=0.251). 结论 塑料薄膜包裹可以减少散热,有利于维持正常体温,减少低体温的发生.
目的 探討產房內採用塑料薄膜包裹預防極低齣生體重兒(very low birth weight infant,VLBWI)和超低齣生體重兒(extremely low birth weight infant,ELBWI)髮生低體溫的作用.方法 將2009年6月1日至2010年12月1日在溫州醫科大學附屬第二醫院(育英兒童醫院)產科齣生併立即收住新生兒科的早產兒(齣生體重＜1 500 g且齣生胎齡＜33週)209例,隨機分為包裹組105例和未包裹組104例.包裹組用塑料薄膜包裹其軀榦及四肢(頭麵部不包裹,留齣臍帶,鬆緊以不妨礙肢體活動為準),併戴上帽子;若有新生兒窒息複囌或其他操作,則迅速包裹塑料薄膜,以不妨礙操作為宜.未包裹組隻戴帽子,不用塑料薄膜包裹.觀察2組患兒轉入新生兒科時的體溫、血糖、1h內動脈血氣分析以及病死率等情況.採用t檢驗或x2檢驗對2組數據進行比較. 結果 包裹組早產兒平均入院體溫為(36.1±0.8)℃,高于未包裹組早產兒平均入院體溫[(35.5±1.0)℃,t=4.707,P＜0.01];包裹組入院低體溫的髮生率為41.0％(43/105),低于未包裹組[66.3％(69/104),x2=13.547,P＜0.01];胎齡＜29週的VLBWI中,包裹組平均入院體溫為(36.1±0.8)℃,高于未包裹組的(35.4±1.1)℃,差異有統計學意義(t=3.051,P＜0.01);胎齡≥29週的VLBWI中,包裹組平均入院體溫為(36.0±0.9)℃,高于未包裹組的(35.5±0.9)℃,差異有統計學意義(t=3.698,P＜0.01).包裹組與未包裹組動脈血氣分析的堿剩餘值分彆為-(2.9±2.7) mmol/L和-(5.0±4.2)mmol/L,差異有統計學意義(t=4.473,P＜0.01).包裹組早產兒入院後氣管插管率為20.0％(21/105),未包裹組為27.9％(29/104),差異無統計學意義(x2=1.785,P=0.182);包裹組與未包裹組病死率分彆為7.0％(7/100)和11.1％ (11/99),差異無統計學意義(x2=1.023,P=0.312);包裹組齣院患兒住院時間為(49.2±10.7)d,未包裹組為(45.8±9.1)d,差異亦無統計學意義(t=1.152,P=0.251). 結論 塑料薄膜包裹可以減少散熱,有利于維持正常體溫,減少低體溫的髮生.
목적 탐토산방내채용소료박막포과예방겁저출생체중인(very low birth weight infant,VLBWI)화초저출생체중인(extremely low birth weight infant,ELBWI)발생저체온적작용.방법 장2009년6월1일지2010년12월1일재온주의과대학부속제이의원(육영인동의원)산과출생병립즉수주신생인과적조산인(출생체중＜1 500 g차출생태령＜33주)209례,수궤분위포과조105례화미포과조104례.포과조용소료박막포과기구간급사지(두면부불포과,류출제대,송긴이불방애지체활동위준),병대상모자;약유신생인질식복소혹기타조작,칙신속포과소료박막,이불방애조작위의.미포과조지대모자,불용소료박막포과.관찰2조환인전입신생인과시적체온、혈당、1h내동맥혈기분석이급병사솔등정황.채용t검험혹x2검험대2조수거진행비교. 결과 포과조조산인평균입원체온위(36.1±0.8)℃,고우미포과조조산인평균입원체온[(35.5±1.0)℃,t=4.707,P＜0.01];포과조입원저체온적발생솔위41.0％(43/105),저우미포과조[66.3％(69/104),x2=13.547,P＜0.01];태령＜29주적VLBWI중,포과조평균입원체온위(36.1±0.8)℃,고우미포과조적(35.4±1.1)℃,차이유통계학의의(t=3.051,P＜0.01);태령≥29주적VLBWI중,포과조평균입원체온위(36.0±0.9)℃,고우미포과조적(35.5±0.9)℃,차이유통계학의의(t=3.698,P＜0.01).포과조여미포과조동맥혈기분석적감잉여치분별위-(2.9±2.7) mmol/L화-(5.0±4.2)mmol/L,차이유통계학의의(t=4.473,P＜0.01).포과조조산인입원후기관삽관솔위20.0％(21/105),미포과조위27.9％(29/104),차이무통계학의의(x2=1.785,P=0.182);포과조여미포과조병사솔분별위7.0％(7/100)화11.1％ (11/99),차이무통계학의의(x2=1.023,P=0.312);포과조출원환인주원시간위(49.2±10.7)d,미포과조위(45.8±9.1)d,차이역무통계학의의(t=1.152,P=0.251). 결론 소료박막포과가이감소산열,유리우유지정상체온,감소저체온적발생.
Objective To evaluate the effectiveness of occlusive wrapping with plastic film in the delivery room to prevent heat loss and reduce the occurrence of hypothermia on admission to the Neonatal Intensive Care Unit (NICU) in very low birth weight infants.Methods A total of 209 very low birth weight infants (birth weight＜1 500 g and gestational age＜33 weeks),born in the Second Hospital of Wenzhou Medical University (Yuying Children's Hospital) and admitted to the NICU immediately after birth from June 1,2009 to December 1,2010,were randomized to the wrap group or non-wrap group.Infants randomized to the wrap group were dried and then wrapped with polyethylene film up to their necks immediately after delivery.They were then covered with warmed blankets and transported to the NICU by the neonatal team.The non-wrap group received routine care in the delivery room following the guidelines of the Neonatal Resuscitation Program.The t test and Chi-square test were used for statistical analysis.Results The mean rectal temperature on admission to the NICU was significantly higher in infants of wrap group compared with those of non-wrap group [(36.1 ± 0.8) ℃ vs (35.5 ± 1.0) ℃,t=4.707,P＜0.01],and the incidence of hypothermia was 41.0％ (43/105) in the wrap group which was lower than that in the non-wrap group (66.3％,69/104) (x2=13.547,P＜0.01).In infants ＜29 weeks of gestation,the mean rectal temperature on admission to the NICU was higher in the wrap group than in the non-wrap group [(36.1 ± 0.8) ℃ vs (35.4 ± 1.1) ℃,t=3.051,P＜0.01].In infants ≥ 29 weeks of gestation,the mean rectal temperature on admission to the NICU was higher in the wrap group than in the non wrap group [(36.0±0.9) ℃ vs (35.5±0.9) ℃,t=3.698,P＜0.01].The arterial blood gas base excess in the wrap group and non-wrap group was-(2.9±2.7) mmol/L and-(5.0±4.2) mmol/L,respectively (t=4.473,P＜0.01).The rate of endotracheal intubation was 20.0％ (21/105) in the wrap group and 27.9％ (29/104) in the non-wrap group,(x2=1.785,P=0.182).The duration of hospitalization was (49.2± 10.7) d in the wrap group and (45.8±9.1) d in the non-wrap group,and the difference was not statistically significant (t=1.152,P=0.251).Conclusions Wrapping very low birth weight infants with plastic film in the delivery room can reduce the occurrence of hypothermia.
