Galligan Maura
Beth Israel Deaconess Medical Center, Boston, MA, USA.
MCN Am J Matern Child Nurs. 2006 Sep-Oct;31(5):298-304; quiz 305-6. doi: 10.1097/00005721-200609000-00007.
Hypothermia is not uncommon in full-term, low-risk newborns during the first days of life. Standard care for treating hypothermia often involves the separation of the mother and the newborn while the infant is placed under a warmer and observed in the nursery. Because one important role of the postpartum nurse is to promote mother-infant attachment by encouraging the mother to spend time "getting to know" her infant, this separation can be problematic. This article proposes that skin-to-skin (STS) care, also called kangaroo care, an intervention in which the unclothed, diapered infant is placed on the mother's bare chest, be used to promote thermoregulation instead of using separation and a warmer. STS care has been recognized as a way to facilitate maternal-infant attachment and promote thermoregulation. The literature review here provides an analysis of the available evidence and the author's conclusion that the research supports the use of STS care as an alternative to traditional rewarming. The evidence was graded and organized into an evidence-based practice guideline for the use of STS care in the treatment of mild hypothermia in the low-risk infant. Suggestions for further research and outcomes measurement are included.
体温过低在足月儿、低风险新生儿出生后的头几天并不罕见。治疗体温过低的标准护理通常包括将母亲和新生儿分开，同时将婴儿放在暖箱下并在育婴室进行观察。由于产后护士的一个重要职责是通过鼓励母亲花时间“了解”她的婴儿来促进母婴依恋，这种分离可能会产生问题。本文提出，皮肤接触（STS）护理，也称为袋鼠式护理，即将未穿衣服、仅裹尿布的婴儿放在母亲裸露的胸部上的一种干预措施，可用于促进体温调节，而不是采用分离和暖箱。皮肤接触护理已被认为是促进母婴依恋和调节体温的一种方式。此处的文献综述对现有证据进行了分析，作者得出结论，研究支持使用皮肤接触护理作为传统复温方法的替代方案。对证据进行了分级，并整理成一份基于证据的实践指南，用于在低风险婴儿中使用皮肤接触护理治疗轻度体温过低。文中还包括了进一步研究和结果测量的建议。
