张玉花 李菲菲 林净 林丽君 　陈冰

【摘要】 目的：研究暖链管理对早产儿黄金小时体温的积极意义。方法：选取2017年5月-2018年7月使用车载暖箱转入笔者所在医院NICU的早产儿92例为研究对象，采用随机分配方式将早产儿分为对照组与观察组，各46例。对照组接受常规护理干预，观察组实施暖链管理强化措施。对比两组低体温发生率、体温水平及并发症发生率。结果：观察组低体温发生率及并发症发生率均明显低于对照组，体温水平明显高于对照组，差异均有统计学意义（P<0.05）。结论：强化暖链管理对早产儿黄金小时体温管理效果显著，应在护理管理实践中推广应用。

【关键词】 暖链管理 早产儿 黄金小时 体温

doi：10.14033/j.cnki.cfmr.2019.28.076 文献标识码 B 文章编号 1674-6805（2019）28-0-02

Effect of Strengthening Measures of Warm Chain Management on the Body Temperature of Premature Infants during Golden Hour/ZHANG Yuhua， LI Feifei， LIN Jing， LIN Lijun， CHEN Bing. //Chinese and Foreign Medical Research， 2019， 17（28）： -178

[Abstract] Objective： To study the positive significance of warm chain management on the body temperature of premature infants during golden hour. Method： From May 2017 to July 2018， a total of 92 premature infants who were transferred to the NICU of our hospital with car heating boxes were selected as subjects. The premature infants were randomly divided into the control group and the observation group， with 46 cases in each group. The observation group implemented the strengthening measures of warm chain management. The incidence of hypothermia， body temperature level and complications rate were compared between the two groups. Result： The incidence of hypothermia and complications rate in the observation group were significantly lower than those of the control group， and body temperature level was significantly higher than that of the control group， and the differences were statistically significant （P<0.05）. Conclusion： Strengthening of warming chain management has a significant effect on the body temperature of premature infants during golden hour， and it should be popularized and applied in nursing management practice.

[Key words] Warm chain management Premature infants Golden hour Body temperature

First-authors address： The 95th Hospital of the Chinese Peoples Liberation Army， Putian 351100， China

隨着社会飞速发展，二胎政策开放，高龄产妇增加，使早产儿发生率越来越高。早产儿因自身生理特点，发病后具有病情变化快，死亡率高的特点[1]。早产儿出生后适应母体外的环境是一个复杂的过程，出生后从产房一直到入住新生儿重症监护室（NICU）的1 h内，一个重要环节是保持体温正常。在出生后最初1 h称为“黄金小时”[2]。早产儿不仅会经历从宫内到宫外生存环境的巨大改变，还可能会经历复苏，应用肺泡表面活性物质，机械通气，建立静脉通道，转运至NICU，脐动、静脉置管等一系列操作，如何维持正常体温是一个重要挑战。早产儿在出生后几分钟内最容易发生低体温现象[3]。WHO提出的保护新生儿体温的“暖链”管理对临床具有意义[4]。针对早产儿应及时快速实施保暖措施，落实黄金小时内体温管理，降低入住NICU前低体温所导致的相关并发症发生率，为早产儿争取更多救治时间，提高救护效果。……