不同姿勢擺位對早產兒生理指標之影響

Effects of Different Lying Positions on Physiological Parameters ofPreterm 1nfants

早產兒出生後長時間躺臥在保溫箱中，姿勢擺位對其生長發展有相當顯著的影響，故本研究之目的是要探討早產兒接受不同臥姿擺位對其生理指標的影響。研究採類實驗研究設計，以北部某醫學中心之新生兒加護病房的早產兒為研究對象。每位符合收案標準的早產兒，由研究者將每一位早產兒都依序擺位四種不同的臥躺姿勢，姿位改變後30分鐘開始連續測量其每一分鐘的平均生理數值，共測量30分鐘。本研究共收集60位早產兒，研究結果顯示仰臥、側臥、俯臥、半俯臥時生理指標之平均值為HR：156、155、155、155 bpm；RR：45.4、45.7、45.2、45.3 bpm；O2 Sat.：96.2、96.4、97.0、97.3％。其中俯臥和半俯臥對提升血氧飽和濃度有顯著的統計意義（p＜.001）。潛在性壓力的異常生理值（vital signs indicating potential stress）出現的次數，在姿勢擺位為俯臥及半俯臥時比仰臥和側臥少，而半俯臥時的血氧飽和濃度出現異常值次數則比俯臥時少（p＜.001）。本研究結果顯示，早產兒姿勢擺位為半俯臥時比俯臥姿勢更能促進早產兒的氧合作用。The preterm infants have to stay in the incubator after birth, and the lying positions have great impacts on their growth and development. This study aims to examine the influences of different lying positions on the preterm infants' physiological parameters. Quasi-experimental design was applied in this study. Participants were preterm infants choosing from a neonatal intensive care unit at a medical center in northern Taiwan. The preterm infants who met the inclusion criteria were positioned sequentially in four different lying positions by the researcher. The physiological parameters of the participants were measured every minute for 30 consecutive minutes after the lying position had been changed and maintained for 30 minutes. A total of 60 preterm infants were enrolled in this study. The results of the means of the physiological parameters in supine, lateral, prone or semiprone positions are as follows: heart rates are 156, 155, 155 and 155 beats per minute; respiratory rates are 45.4, 45.7, 45.2 and 45.3 times per minute; oxygenation saturations (SaO2) are 96.2, 96.4, 97.0 and 97.3% respectively. The level of SaO2 is significantly higher in prone and semiprone positions (p< .001) than in supine and lateral positions. There are fewer episodes of vital signs indicating potential stress in prone and semiprone positions than in supine and lateral positions (p<.001). The frequencies of abnormal data in SaO2 are less occurred in semiprone position than in the prone position (p<.001). This study indicates that lying in semiprone position provided a better oxygenation for preterm infants.