箱温波动对极/超低出生体质量儿脑室内出血的影响研究  

Correlation of early fluctuation management on intraventricular hemorrhage in very/extremely low birth weight infant

作　　者：袁瑞琴[1] 杨传忠[2] 熊小云[2] 陈丽莲[2] 黄颖穗[2] 曹爱芬[2] Yuan Ruiqin;Yang Chuanzhong;Xiong Xiaoyun;Chen Lilian;Huang Yingsui;Cao Aifen(Newborn Department of Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University Shenzhen 518028, China;Neonatal Intensive Care Unit of Ajfdiated Shenzhen Maternity & Child Healthcare Hospital, Shenzhen 51802,China)

机构地区：[1]深圳市妇幼保健院新生儿科,518028 [2]深圳市妇幼保健院NICU,518028

出　　处：《中国实用护理杂志》2019年第14期1051-1055,共5页Chinese Journal of Practical Nursing

基　　金：深圳市科技创新委员会立项课题(JCYJ20150402090413019);深圳市"医疗卫生三名工程"资助项目(SZSM201612045).

摘　　要：目的探讨箱温波动对极/超低出生体质量儿(V/ELBW)脑室内出血(IVH)发生的关系研究。方法收集2015年7月至2016年9月深圳市妇幼保健院NICU270例住院的V/ELBW的入院肛温、72 h内的暖箱温度和腹部温度以及常规临床资料,并记录其IVH的发生情况,根据有无IVH分为IVH组与非IVH组,应用卡方检验、独立样本t检验、秩和检验及多因素Logistic回归分析探讨V/ELBW早期箱温波动对IVH发生的影响。结果270例V/ELBW纳入研究,其IVH发病率24.4%(66/270),严重IVH(Ⅲ~Ⅳ级)发病率5.2%(14/270)。单因素分析显示,除胎龄、体质量、1/5 min Apgar评分、性别、生产方式、妊娠期高血糖、产前激素使用以及机械通气等常见IVH危险因素外,箱温波动和腹壁体温波动均与V/ELBW发生IVH相关(P<0.05)。对以上相关的危险因素进行Logistic回归分析表明,除了性别(OR=0.42)、高血糖(OR=3.67)和1 min Apgar评分(OR=0.71)外,箱温波动(OR=1.10)也是V/ELBW发生IVH的独立危险因素(P均<0.05)。结论箱温波动是V/ELBW发生IVH的独立危险因素,提示我们在集中诊疗护理操作的同时应尽量缩短操作时间,以减少暖箱温度波动的次数和体温波动的范围及次数,降低IVH的发生率,提高生命质量。Objective To investigate the correlation of early incubator temperature fluctuation on intraventricular hemorrhage (IVH) in very/extremely-low birth weight infants (E/VLBW). Methods From July 2015 to September 2016, 270 patients of hospitalized E/VLBW were included in this study. Temperature changes including incubator temperature and abdominal temperature within 72 hours after admission and routine clinical data were collected,the E/VLBW were divided into IVH group and non-IVH group, as well as the occurrence and grading of IVH. Chi-square test, t test and nonparametric test and logistic regression analysis were used to explore the effect of early incubator temperature fluctuations in E/VLBW on IVH. Results Of the 270 V/ELBW studied, the incidence of IVH was 24.4%(66/270), severe IVH(grade Ⅲ and Ⅳ) was 5.2%(14/270). Univariate analysis showed that in addition to common IVH risk factors such as gestational age, body weight, 1/5 min Apgar score, sex, delivery, hyperglycemia, prenatal steroid and mechanical ventilation, fluctuations of body temperature and incubator temperature were relevant for IVH in E/VLBW (P<0.05). Logistic regression analysis of the above relevant risk factors showed fluctuations of temperature (OR=1.10) was also an independent risk factor for IVH in E/VLBW(P<0.05), in addition to sex(OR=0.42), 1 min Apgar score (OR=0.71), and hyperglycemia (OR=3.67). Conclusion Fluctuation of incubator temperature is an independent risk factor for IVH in V/ELBWI. During centralized nursing and nursing operations, the operating time should be shortened as much as possible to reduce the number of fluctuations of incubators and body temperature to reduce the incidence of IVH and improve the quality of life.

关 键 词：温度 护理 极/超低出生体质量儿 脑室内出血 

分 类 号：R473.72[医药卫生—护理学]