早产儿出生后黄金小时体温集束化管理对入院体温及临床结局的影响

Effect of golden-hour body temperature bundle management on admission temperature and clinical outcome in preterm infants after birth

摘要:

目的 探讨 < 34周早产儿出生后黄金小时体温集束化管理策略对入院体温及临床结局的影响。方法 纳入2015年12月至2016年6月及2017年1~5月在四川大学华西第二医院产房出生后1 h内转入该院新生儿科的早产儿为研究对象，其中2017年1~5月收治的早产儿为干预组（173例），采用黄金小时体温集束化管理措施；2015年12月至2016年6月收治的早产儿为对照组（164例），采用常规的体温管理方法。结果 干预组患儿入院平均体温高于对照组（36.4±0.4℃ vs 35.3±0.6℃，P < 0.001）。干预组入院低体温发生率低于对照组（56.6% vs 97.6%，P < 0.001）。干预组患儿入院1周内颅内出血发生率低于对照组（15.0% vs 31.7%，P < 0.05）。结论 对早产儿出生后1 h内实施黄金小时体温集束化管理，可降低其入院低体温的发生，改善临床结局。

Abstract:

Objective To study the effect of golden-hour body temperature bundle management strategy on admission temperature and clinical outcome in preterm infants with a gestational age of < 34 weeks after birth.Methods The preterm infants who were born in the delivery room of the West China Second University Hospital of Sichuan University and admitted to the department of neonatology of this hospital within 1 hour after birth from December 2015 to June 2016 and from January to May, 2017 were enrolled. The 173 preterm infants who were admitted from January to May, 2017 were enrolled as the intervention group and were given golden-hour body temperature bundle management. The 164 preterm infants who were admitted from December 2015 to June 2016 were enrolled as the control group and were given conventional body temperature management.Results The intervention group had a significantly higher mean admission temperature than the control group (36.4±0.4℃ vs 35.3±0.6℃; P < 0.001). The incidence rate of hypothermia on admission in the intervention group was significantly lower than that in the control group (56.6% vs 97.6%; P < 0.001). The intervention group had a significantly lower incidence rate of intracranial hemorrhage within one week after admission than the control group (15.0% vs 31.7%; P < 0.05).Conclusions Golden-hour body temperature bundle management for preterm infants within one hour after birth can reduce the incidence of hypothermia on admission and improve clinical outcome.