極早期袋鼠式護理對低體溫新生兒子宮外體溫適應的成效

Effect of Very Early Kangaroo Care on Extrauterine Temperature Adaptation in Newborn Infants with Hypothermia Problems

新生兒離開母體後，需要獨立面對各項生理的變化，體溫調節是新生兒出生後重要的調適過程，新生兒體溫若低淤36℃，將可能會增加其致病率與死亡率。本研究旨在探討極早期袋鼠式護理對於低體溫新生兒子宮外體溫之適應，本研究屬隨機控制試驗，以剖腹產出生之新生兒為收案族群，共收案78對健康之母嬰，實驗組於出生後於恢復室與母親進行極早期袋鼠式護理，而控制組則於嬰兒室使用輻射加溫器下依常規進行照護，隨後比較兩組新生兒出生後體溫適應之過程。研究結果發現實驗組進行30分鐘的袋鼠式護理後的平均肛溫為36.29℃，高於對照組的36.22℃（p=.044），後續追蹤兩組新生兒體溫回復情形，實驗組於第4小時測得新生兒體溫達36.5℃之累計百分比為97.43%，高於控制的82.05%，顯示極早期袋鼠式護理對於低體溫新生兒子宮外體溫適應上是一項安全、且具效益的護理措施，期望藉由此實證性研究，提供臨床上醫護人員照護低體溫新生兒時的參考。

Increased morbidity and mortality has been associated with neonates admitted with body temperatures below 36℃. We employed an experimental design in a randomized control trial to compare the effectiveness of using early kangaroo care (KC) for extrauterine temperature adaptation against that of using radiant warmers. Trial subjects included 78 consecutive cesarean newborn infants with hypothermia problems. The KC group received skin-to-skin contact with their mothers in the post-operative room, while infants in the control group received routine care under radiant warmers. The mean temperature of the KC group was slightly higher than that of the control group (36.29℃ vs. 36.22℃, p=.044). After four hours, 97.43% of KC group infants had reached normal body temperatures, compared with 82.05% in the radiant warmer group. Results demonstrate the positive effects of KC for extrauterine temperature adaptation in hypothermia infants. In the course of evidence-based practice, KC could be incorporated into the standard care regimen in order to improve hypothermia care.