Fransson A-L, Karlsson H, Nilsson K
The Queen Silvia Children's Hospital, SE-416 85 Göteborg, Sweden.
Arch Dis Child Fetal Neonatal Ed. 2005 Nov;90(6):F500-4. doi: 10.1136/adc.2004.066589.
Hypothermia is a major cause of deterioration and death in the neonatal period. Temperature deviations are key signs of illness.
To determine normal patterns of temperature variation in newborn babies and the influence of external factors.
Abdominal and foot skin temperature were continuously recorded in 27 healthy full term babies during the first two days of life and related to the care situation-that is, whether the baby was with the mother or in its cot. The recordings were made using no wires to avoid interference with the care of the neonate. Ambient temperature was close to 23 degrees C during the study period.
Mean rectal and abdominal and foot skin temperature were lower on day 1 than day 2. The foot skin temperature was directly related to the care situation, being significantly higher when the baby was with the mother. The abdominal skin temperature was much less influenced by external factors. When the neonates were with their mothers, the mean difference between rectal temperature and abdominal skin temperature was 0.2 degrees C compared with a mean difference between rectal temperature and foot skin temperature of 1.5 degrees C, indicating a positive heat balance. In the cot the corresponding temperature differences were 0.7 degrees C and 7.5 degrees C. A temperature difference between rectal and foot skin temperature of 7-8 degrees C indicates a heat loss close to the maximum for which a neonate can compensate (about 70 W/m2).
This study emphasises the importance of close physical contact with the mothers for temperature regulation during the first few postnatal days.
体温过低是新生儿病情恶化和死亡的主要原因。体温偏差是疾病的关键体征。
确定新生儿体温变化的正常模式以及外部因素的影响。
在27名健康足月儿出生后的前两天连续记录其腹部和足部皮肤温度,并将其与护理情况相关联,即婴儿是与母亲在一起还是在婴儿床中。记录时不使用电线以避免干扰新生儿护理。研究期间环境温度接近23摄氏度。
第1天的平均直肠温度、腹部温度和足部皮肤温度低于第2天。足部皮肤温度与护理情况直接相关,当婴儿与母亲在一起时显著更高。腹部皮肤温度受外部因素的影响小得多。当新生儿与母亲在一起时,直肠温度与腹部皮肤温度的平均差值为0.2摄氏度,而直肠温度与足部皮肤温度的平均差值为1.5摄氏度,表明热量平衡为正。在婴儿床中的相应温度差值分别为0.7摄氏度和7.5摄氏度。直肠温度与足部皮肤温度的差值为7 - 8摄氏度表明热量损失接近新生儿能够代偿的最大值(约70 W/m²)。
本研究强调了产后头几天与母亲密切身体接触对体温调节的重要性。