Efficacy and safety of the heated gel mattress for prevention of hypothermia in preterm infants during intra-hospital transport： a meta-analysis  

作　　者：Ya-Qian Liu Meng-Jie Lei Ting-Ting Liu Yu-Feng Li Chu-Yun Cui Li-Jia Ni Chang-De Jin 

机构地区：[1]Department of Graduate, Tianjin University of Traditional Chinese Medicine, Tianjin, China [2]Department of gynaecology and obstetrics, Tianjin Center Obstetrics and Gynecology Hospital, Tianjin, China [3]Department of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China

出　　处：《TMR Integrative Nursing》2018年第3期132-140,共9页TMR整合护理

摘　　要：Objective： To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods： Systematic searches on PubMed, EM- BASE, Cochrane Library, Web of Science, CBM, CNKI, Wanfang and VIP were performed for randomized controlled trials （RCTs） or quasi-RCTs which explored the effects of heated gel mattress on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria, extracted data and assessed quality. Then, meta-analysis and trial sequential analysis were performed by RevMan 5.3 and TSA vO.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results： This systematic review included 10 studies which comprised 7 RCTs and 3 quasi-RCTs, encompassing 773 patients. The results of meta-analysis showed that in heated gel mattress group admission temperature on neonatal intensive care unit （SMD, 0.63; 95% CI, 0.40 to 0.87; P = 0.00）, incidence of hypothermia （RR, 0.73; 95% CI, 0.57 to 0.93; P = 0.01） and hyperthermia （RR, 1.82; 95% CI, 1.31 to 2.541 P = 0.00） compared with the control group had significantly statistical difference; however, there was no significant difference in admission temperature on exothermic mattresses or TransWarmer mattress group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage Ⅲ/Ⅳ between two groups, trial sequential analysis confirmed that the pooled results of admission temperature on neonatal intensive care unit and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusion： Heated gel mattress is a safe and effective re- warming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia and does not increase the 目的：系统评价转运中加热凝胶床垫对低体温早产儿复温效果的有效性和安全性。方法：计算机检索PubMed、EMBASE、Cochrane Library、Web of Science，中国生物文献数据库、中国学术期刊全文数据库、万方和维普等国内外数据库中有关加热凝胶床垫应用于早产儿低体温复温的随机对照试验或半随机试验。对获得文献根据纳入与排除标准进行文献筛查、资料提取、文献质量评价，采用RevMan513统计软件进行Meta分析，采用丹麦哥本哈根临床试验中心开发的TSA v0．9软件进行试验序贯分析。结果：共纳入7篇随机对照试验，3篇类试验，共包括773例患儿。Meta分析结果显示，使用加热凝胶床垫入新生儿重症监护治疗病房（NICU）时体温[SMD=0．63，95％CI（0．40，0．87），P=0．00]、低体温发生率[RR=0．73，95％CI（0．57，0．93），P=0．01]、高热[RR=1．82，95％ClI（1．31，2．54），P=0．00]，合并效应有统计学意义；而在使用放热床垫、超温床垫进入NICU时体温，死亡率，脓毒血症，早期视网膜病变，3至4级脑室内出血方面并无统计学意义。试验序贯分析显示，入NICU时体温和高温指标Meta分析结果稳定且可靠，但低温发生率、死亡率指标合并结果提示样本量不足。结论：加热凝胶类型床垫是安全有效的复温辅助干预措施，可提高转运过程中低温早产儿入NICU时体温，降低低体温发生率且不增加死亡率和并发症的发生率，但建议临床使用时应动态监测体温以降低高热的潜在风险。此外，其成本效益和对远期结局指标的长期影响需要通过临床多中心、大样本、高质量的研究进一步评价。

关 键 词：Premature infants HYPOTHERMIA Intra-hospital transport Temperature management META-ANALYSIS Trial sequential analysis 

分 类 号：R722[医药卫生—儿科]