Sutter T W, Phan D, Pierchala C E, Rishel W
Neonatal Intensive Care Unit, Saint Mary of the Plains Hospital, Lubbock, TX 79410.
J Perinatol. 1988 Summer;8(3):193-8.
Thirty pairs of healthy, growing preterm infants were included in this randomized prospective study comparing thermal weaning at 1700 g with that at 1800 g. Based on an intention-to-treat analysis, infants weaned at 1700 g were discharged 1.1 days sooner than those weaned at 1800 g. However, this result was not statistically significant (p = 0.13). On the other hand, differences are apparent between treatments in some strata based on birth weight (p = 0.0056). Evidence also existed that time from entry (at 1500 g) to discharge depended on birth weight stratum (p = 0.010). No infant in either group lost weight after successful weaning, and mean 24-hour weight gains were similar for both groups. Two infants were weaned at 1800 g requiring return to the incubator due to hypothermia, and four infants weaned at 1700 g likewise requiring return to the incubator. The number weaned at 1700 g who had birth weight of 1000 g or less and who developed hypothermia appeared substantial (three of six such infants). Thus, it appears that thermal weaning at 1700 g may be safe and effective only for prematures with birth weight above 1000 g. Additional study appears needed.
这项随机前瞻性研究纳入了30对健康成长的早产儿，比较了体重1700克时与1800克时的体温下调情况。基于意向性分析，体重1700克时进行体温下调的婴儿比体重1800克时进行体温下调的婴儿提前1.1天出院。然而，这一结果无统计学意义（p = 0.13）。另一方面，在某些基于出生体重的分层中，不同治疗方法之间存在明显差异（p = 0.0056）。也有证据表明，从入院（体重1500克时）到出院的时间取决于出生体重分层（p = 0.010）。两组中成功下调体温后均无婴儿体重减轻，两组的平均24小时体重增加相似。有两名体重1800克时进行体温下调的婴儿因体温过低需要返回暖箱，有四名体重1700克时进行体温下调的婴儿同样需要返回暖箱。体重1700克、出生体重1000克或更低且出现体温过低的下调体温婴儿数量似乎较多（六名此类婴儿中有三名）。因此，似乎体重1700克时进行体温下调可能仅对出生体重高于1000克的早产儿安全有效。似乎需要进一步研究。
