临床新生儿体温背部测量方法的可行性研究(1)
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【摘要】目的 探讨新生儿体温背部测量法的科学性及可行性。方法 分别对100例新生儿体温进行7、10、30min的腋窝、颌下、背部3种测量,与同时进行的3min肛门测量的体温值进行对照比较。结果 新生儿体温背部测量法与其他部位测量法相同时间内所测体温值差异无统计学意义,P>0.05。背部测量法7、10、30min与肛门测量法(3min)所得的体温值比较,均P>0.05,差异无统计学意义。使用辐射抢救台和暖箱保温的患儿背部测量体温7、10min与肛门测量法所得的体温值比较均P>0.05,差异无统计学意义。而30min的腋窝测量法和颌下测量法与肛门测量法所得的体温值比较则P<0.05,差异有统计学意义。30min的背部测量法与肛门测量法所得的体温值比较P>0.05,差异无统计学意义。结论 新生儿体温背部测量法可以与腋窝测量法、颌下测量法一样应用于护理量较大的临床新生儿科,背部测量法能较准确获得新生儿的真实体温,不受辐射抢救台和暖箱使用的影响,既可以避免患儿受凉,又可减轻护士工作量,安全有效,方便实用,值得临床应用和推广。
【关键词】新生儿 体温 背部测量法 探测时间
, 百拇医药
The Feasibility of Clinical Application of Back Measurement of Neonates Temperature.LI Bin-min,LAI Li,SHI Lan.Meternal and Child Health Hospital of Chengdu Jinniu District,Chengdu 610081,China.
【Abstract】Objective The study aimed to discuss the scientific property and feasibility of back measurement of neonates temperature.Methods Three measurement methods(axillary,under the jaw and the back)were adopted to measure the temoerature for 100 neonates for 7,10 and 30 minutes.The tempera-ture measured by rectum for 3 minutes was set as the control.Results Temperature by back measure-ment was not different from that measured by other methods in the same time period,P>0.05.Temperature by back measurement for 7,10 and 30 minutes was not different from that measured by rectum for 3 minutes,P>0.05.Temperature by back measurement for 7,10 minutes for neonates using radiation rescue plat form and warm case was not defferent from that measured by rectum,P>0.05 Temperature measured by axillary and under the jaw for 30 minutes was different from that measued by recturm,P<0.05.While temperature by back measurement for 30 minutes was different from that measured by rectum,P>0.05.Conclusions Back measurement of temperature as well as by axillary and the jaw could be used in pediatric department .It could accurately obtain the real temperature of neonates and was not influenced by radiation rescue platform and warm case.Besides ,it reduced the workload of nurses and was safe,effective,simple,practical and worth applying widely in clinic.
, 百拇医药
【Key words】Neonate;Temperature;Back measurement;Detection
【中图分类号】R722
【文献标识码】A
【文章编号】1814-8824(2010)-03-0001-04
在新生儿科护理工作中,由于新生儿特别是低出生体重儿体温调节中枢功能不完善,皮下脂肪薄,体表面积相对较大,容易散热,体温容易随外界环境变化而波动,新生儿体温监测成为护士观察患儿病情变化的一项重要技术。临床上新生儿测量体温的常见部位有肛门、腋窝、颌下、背部。而实际工作中由于颌下、背部体温测量方便、安全,此2种方法运用越来越多,但两者在教科书和护理常规中均没列入。作者采用肛门测量法、腋窝测量法、颌下测量法、背部测量法分别对7、10、30min的体温值进行新生儿自身对照研究,旨在为新生儿体温背部测量法的可行性及测量时间提供科学依据,现报道如下。
, http://www.100md.com
1 资料与方法
1.1 一般资料 随机选2007年9月~2008年7月在本院新生儿科住院的患儿100例,结果因测量值不准确而排除5例,其余95例中男59例,女36例,孕周32~40周,日龄1~28d,出生体重量为1.44~4.52 kg,其中体重量在2.50 kg以下39例,2.50 kg及以上56例;于辐射抢救台保暖31例,暖箱保暖6例,无特殊58例。
1.2 方法 统一使用重庆日月温度计有限公司生产的水银柱玻璃体温计,测试前将所用的体温计甩到35℃以下,于同一时间放入40℃水温中3min后取出,逐一检查,体温计读数差异<0.2℃且玻璃管无裂痕者[1]可用作本研究之用。指定新生儿科专人负责,严格按照以下方法测量体温,并记录结果。①肛门测量法和腋窝测量法。按照护理规范操作流程执行[1]。②背部测量法。测量时新生儿取去枕仰卧位,将体温计水银端经一侧(左右均可)颈下插入脊柱与肩胛骨之间斜方肌部位,插入深度为4.5~6.5 cm[2],让新生儿以自身体重量压住体温计于背部。③颌下测量法。测量时新生儿取平卧头侧卧位,将体温计水银端放入颌下,紧贴皮肤,将包被拉起形成一“高领”,使新生儿下颌紧贴胸部,协助扶托,注意避免体温计脱落。95例新生儿均先用肛门测量法测量3min,再用其余3种方法测量7、10、30 min时段,并立即记录体温和当时的病情如哭吵、呕吐等。, http://www.100md.com(李炳敏 赖 丽 史 兰)