暖箱内不同体重新生儿体温测量部位的临床研究

Clinical study of parts of body temperature measurement for incubator newborns with different weights

目的观察暖箱中不同体重的新生儿在不同测量部位的体温差异,为选取合适的体温测量方法提供依据。方法 86例新生儿根据体重分为4组,分别进行颈温、腋温、背温及肛温的测量。结果 （1）不同体重组背部皮下脂肪厚度值差异有统计学意义（P〈0.05）,体重与皮下脂肪厚度值呈正相关关系（r=0.280,P=0.000）。（2）较高体重组（2 000~2 499 g组及2 500~4 000 g组）在生后3 d中颈温、腋温、背温及肛温差异无统计学意义（P值均〈0.05）。低体重组（1 000~1 499 g及1 500~1 999 g组）第1天肛温较颈温（P=0.126）、腋温（P=0.328）及背温（P=0.274）较稍高,差异有统计学意义。第2及第3天不同体重组颈温、腋温、背温及肛温4个部位差异均无统计学意义（P值均〈0.05）。结论暖箱中出生体重较低（低于2 000 g）的新生儿中,生后24 h内应采用肛温的测量方式,以达到准确的体温数值。在正常出生体重或大于2 000 g的新生儿采用背部测量体温的方式较适宜。

Objective To observe the differences of temperature in parts of newborns with different weights in warm boxes,and to provide the basis for the appropriate temperature measurement.Methods 86 cases of newborns were divided into four groups based on body weight.Cervical temperature,axillary temperature,dorsal temperature and rectal temperature were measured respectively.Results（1） Differences in subcutaneous fat thickness in different groups were statistically significant（P0.05）.Body weight and subcutaneous fat thickness were positively correlated（r=0.280,P=0.000）.（2）For the higher weight group（2000~2499g group and 2500~4000g group）,differences in cervical temperature,axillary temperature,dorsal temperature and rectal temperature were not significant in the three days after birth（P0.05）.For the lower weight group（1000~1499g group and 1500~1999g group）,rectal temperature was higher than cervical temperature（P=0.126）,axillary temperature（P=0.328）,and dorsal temperature（P=0.274） in the first day after birth.The differences were statistically significant.Cervical temperature,axillary temperature,dorsal temperature and rectal temperature were not significantly different in the second and third days after birth（P0.05）.Conclusion Rectal temperature measurement should be applied in lower birth weight（below 2000g） newborns in incubators in order to achieve accurate temperature values in the first 24 hours after birth.Measuring of dorsal temperature in normal and above 2000g birth weight newborns is more appropriate.