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早产儿在皮肤接触护理期间及之后的体温调节

Thermoregulation of Premature Infants during and after Skin-to-Skin Care.

作者信息

Heimann K, Ebert A M, Abbas A K, Heussen N, Leonhardt S, Orlikowsky T

机构信息

University Children's Hospital, RWTH Aachen University, Aachen, Germany.

Philips Chair of Medical Information Technology, RWTH Aachen University, Aachen, Germany.

出版信息

Z Geburtshilfe Neonatol. 2013 Dec;217(6):220-4. doi: 10.1055/s-0033-1361175. Epub 2014 Jan 7.

Abstract

OBJECTIVE

Providing normothermia is an important issue in daily routine care of premature neonates. We recently found with infrared thermography (IRT) a drop in skin temperature of premature babies after they were positioned from skin-to-skin care (SSC) back into the incubator. Since this did not disappear within 10 min, we wanted to find out how long it takes until the baby has fully warmed up after SSC and if the IRT measurements correlate with conventional rectal temperature?

STUDY DESIGN

A prospective observational study was undertaken with 5 premature infants [3 male, median gestational age 28 weeks (25-29), median age at study 34 d (28-52), median birth weight 898 g (400-1095), median weight at study 1263 g (790-1465)], temperature was determined with IRT (leg, back, arm, head, upper abdomen; diameter 1 cm, scale 0.00°C), comparison with 2 conventional sensors and rectal temperature. Temperatures were recorded every 2 min and displayed for 4 time points, namely at the beginning and the end of skin-to-skin care (SSC1, SSC2), as well as at the beginning and the end of a subsequent 60 min incubator period (I).

RESULTS

A significant rise during SSC occurred while the cooling after SSC persisted during the complete incubator measurement time (I; p<0.05). Rectal temperature remained stable through the whole measuring period.

CONCLUSION

While SSC in our setting led to an increase in temperature, the lack of compensation of peripheral heat loss in the incubator after 60 min may express an inadequate peripheral regulation of body temperature. This should be taken into account before routine care after SSC.

摘要

目的

在早产儿的日常护理中,维持正常体温是一个重要问题。我们最近通过红外热成像(IRT)发现,早产儿从皮肤接触式护理(SSC)转回保育箱后,皮肤温度会下降。由于这种温度下降在10分钟内没有消失,我们想弄清楚早产儿在进行SSC后需要多长时间才能完全暖和起来,以及IRT测量结果与传统直肠温度是否相关。

研究设计

对5名早产儿[3名男性,中位胎龄28周(25 - 29周),研究时中位年龄34天(28 - 52天),中位出生体重898克(400 - 1095克),研究时中位体重1263克(790 - 1465克)]进行了一项前瞻性观察研究,用IRT(测量腿部、背部、手臂、头部、上腹部;直径1厘米,刻度0.00°C)测定温度,并与2个传统传感器及直肠温度进行比较。每隔2分钟记录一次温度,并在4个时间点显示,即皮肤接触式护理开始和结束时(SSC1、SSC2),以及随后60分钟保育箱观察期开始和结束时(I)。

结果

在SSC期间温度显著上升,而在整个保育箱测量期(I)内,SSC后的降温持续存在(p<0.05)。在整个测量期间,直肠温度保持稳定。

结论

在我们的研究中,虽然SSC导致温度升高,但60分钟后保育箱内周围热量损失缺乏补偿,这可能表明体温的外周调节不足。在SSC后的常规护理之前应考虑到这一点。

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