以聚乙烯製品包覆早產兒身體對於預防失溫之成效

The Effect of Polyethylene Wrap for Prevention of Hypothermia in Preterm Infants

早產兒出生後，因體熱散失、體溫調節功能尚未成熟等因素，造成體溫極不穩定而易發生體溫過低。而目前越來越多研究證實使用聚乙烯膜包覆身體、將軀幹及四肢以聚乙烯袋包覆、或頭戴聚乙烯帽等方式能提升早產兒入院時體溫。故本研究目的為即以系統性文獻回顧方式整合包裹聚乙烯製品對於早產兒體溫維持之實證，搜尋2013 年10 月以前的中、英文文獻，包括華藝線上圖書館、PubMed、Cochrane、Medline、CINAHL 等五個資料庫，最後共得7 篇隨機臨床試驗。研究結果發現，不論是否擦乾身體，以聚乙烯袋包覆身體確實能提升早產兒出生後之體溫，且出生週數越小之早產兒，使用聚乙烯袋防止體溫降低之成效越佳，然而此措施可能造成嬰兒發生過熱之風險，醫護人員應隨時監測實驗組早產兒之體溫，若發生高體溫則需儘速移除包覆在身上的聚乙烯製品，並觀察有無合併症。本研究藉由實證資料的探討與整合，提供更客觀及綜合性的結果，此研究結果可作為臨床維持早產兒體溫照護之措施依據。

Preterm infants remain vulnerable to hypothermia due to heat loss and immature thermoregulation system. More recent studies have demonstrated that admission temperature of preterm infants could be effectively increased through wrapping their body in polyethylene sheets, bag, or wearing plastic caps. The aim of the study was to perform a systematic review to summarize the effectiveness of preventing hypothermia in preterm infants with polyethylene wrap. Literature search was based on Airiti Library, PubMed, Cochrane Library, MEDLINE, and CINAHL. The search was limited to articles published before 2013, October. A total of seven RCTs met the inclusion criteria and were selected for further analysis. Results showed that wrapping body with polyethylene sheet or bag could effectively increase body temperature in preterm infants with or without drying body, especially for infants <28 weeks' gestation. However, the intervention could raise the risk of hyperthermia and therefore infants' temperature should be intensively monitored. If hyperthermia occurred, the polyethylene wrap should be removed and complication should also be observed. This research provides more objective and synthetic result through systematically reviewing evidences. The result can be used as a reference potential for preventing hypothermia of preterm infants for clinical practice.