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一种早产儿保暖固定装置的设计与应用

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目的 自制早产儿保暖固定装置,并探讨其临床应用效果.方法 设计早产儿保暖固定装置,并用于临床.选取首都医科大学附属北京儿童医院保定医院新生儿科病房于 2022 年 1 月至 6 月收治的 60 例早产儿作为对照组,2022年7月至12月收治的60例早产儿作为试验组.对照组早产儿使用阿童木暖箱辐射保暖、约束带或人为约束的方式进行脐静脉置管或中心静脉置管.试验组早产儿使用自行设计的早产儿保暖固定装置于阿童木暖箱中辐射保暖进行置管.记录两组早产儿置管时间、肢体脱出次数、置管参与人数、置管 20 min至置管结束时的体温,并计算发生低体温(<36.5℃)的频率,比较两组各指标的差异.结果 ①早产儿保暖固定装置由保暖睡袋和软垫两部分组成.保暖睡袋包括头部、手臂部、胸腹部和下肢部 4 个部分,其中胸腹部设计有长方形覆盖布料,掀开便于对早产儿行脐静脉穿刺.长方形软垫上有 3 组约束带,可分别固定保暖睡袋手臂部、胸腹部、下肢部.置管操作时,用魔术贴将保暖睡袋固定在软垫表面,根据穿刺部位选择暴露皮肤的范围.②试验组与对照组早产儿性别、体质量、孕周对比差异均无统计学意义[男性:48.3%比 46.7%,体质量(kg):1.86±0.06 比 1.82±0.06,孕周(周):31.33±0.31 比 32.25±0.34,均P>0.05].与对照组比较,试验组置管时间明显缩短(min:21.30±0.43比30.02±0.64,P<0.01),肢体脱出次数明显减少(0次:70.0%比33.3%,1次:26.7%比 50.0%,P<0.01),置管参与人数明显减少(人:1.77±0.06 比 2.37±0.06,P<0.01).试验组早产儿低体温发生率明显低于对照组[6.12%(6/98)比 26.50%(31/117),χ2=15.536,P<0.01].结论 早产儿保暖固定装置使用方便,可有效缩短置管时间,节约人力资源,减少早产儿低体温发生.
Design and application of a warming fixation device for premature infants
Objective A warming fixation device for premature infants was made and its clinical application effect was discussed.Methods The warming fixation device for premature infants was designed and used in clinic.Sixty premature infants admitted to the neonatal ward of Baoding Hospital,Beijing Children's Hospital,Capital Medical University from January to June 2022 were selected as the control group,and 60 premature infants admitted from July to December 2022 were selected as the experimental group.In the control group,umbilical vein catheterization or central vein catheterization were performed using Astro Boy heating box,restraint band or artificial restraint.The preterm infants in the experimental group were radiated into the Astro Boy warm box with self-designed preterm warming fixation device for catheterization.The time of catheterization,the number of limb protrusion,the number of participants in catheterization operation,and the body temperature from 20 minutes of catheterization operation to the end of catheterization operation were recorded in the two groups.The frequency of hypothermia(<36.5℃)was calculated,and the differences in various indexes between the two groups were compared.Results ①The warming fixation device for premature babies consists of two parts:warm sleeping bag and soft pad.The warm sleeping bag includes 4 parts:head,arm,chest and abdomen,and lower limbs.The chest and abdomen were designed with rectangular covering cloth,which can be opened to facilitate umbilical vein puncture for premature infants.There were 3 groups of restraint belts on the rectangular soft pad,which can respectively fix the arms,chest and abdomen of the warm sleeping bag and the lower limbs.During the catheterization operation,use Velcro to secure the warm sleeping bag to the cushioned surface,and select the area of exposed skin according to the piercing site.②There were no significant differences in gender,body weight and gestational age between the experimental group and the control group[male:48.3%vs.46.7%,body weight(kg):1.86±0.06 vs.1.82±0.06,gestational age(weeks):31.33±0.31 vs.32.25±0.34,all P>0.05].Compared with the control group,the catheterization time of experimental group was significantly shortened(minutes:21.30±0.43 vs.30.02±0.64,P<0.01),the number of limb protrusion was significantly reduced(0 time:70.0%vs.33.3%,1 time:26.7%vs.50.0%,P<0.01),and the number of participants in catheterization operation was significantly reduced(people:1.77±0.06 vs.2.37±0.06,P<0.01).The frequency of hypothermia in experimental group was significantly lower than that in the control group[6.12%(6/98)vs.26.50%(31/117),χ2 = 15.536,P<0.01].Conclusion The warming fixation device for premature infants is convenient to use,which can effectively shorten the tube placement time,save human resources,and reduce the incidence of hypothermia in premature infants.

Central vein catheterizationPremature infantThermal care interventionDesignApplication

李会仙

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首都医科大学附属北京儿童医院保定医院NICU,河北保定 071000

中心静脉置管 早产儿 保暖 设计 应用

国家实用新型专利河北省保定市科技计划项目

ZL 202221431116.72341ZF388

2024

中华危重病急救医学
中华医学会

中华危重病急救医学

CSTPCD北大核心
影响因子:3.049
ISSN:2095-4352
年,卷(期):2024.36(2)
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