摘要
目的系统评价塑料薄膜包裹对新生儿保暖效果的有效性及安全性,以期为临床新生儿保暖措施的选择提供依据。方法计算机检索Cochrane Library、Pub Med、Scopus、中国生物医学文献数据库、万方、维普、中国学术期刊全文数据库等国内外数据库中有关塑料薄膜包裹应用于新生儿保暖的随机对照研究。对所得文献依据纳入与排除标准进行筛查,提取资料,评价文献质量,采用Rev Man 5.2软件进行Meta分析。结果最终纳入16项随机对照试验,包括2 836例研究对象。Meta分析结果显示,塑料薄膜包裹组早产儿进入NICU时低体温发生率[RR=0.71,95%CI (0.64,0.79),P<0.01]、进入NICU时体温[MD=0.60,95%CI (0.47,0.72),P<0.01]、进入NICU时发热发生率[RR=4.09,95%CI(2.12,7.88),P<0.01]与常规护理组相比,差异具有统计学意义;Ⅲ度或Ⅳ度脑室内出血发生率[RR=0.92,95%CI(0.65,1.32),P=0.660]、出院前病死率[RR=0.75,95%CI(0.53,1.08),P=0.120]与常规护理组相比,差异无统计学意义。结论塑料薄膜包裹能减少早产儿进入NICU时低体温的发生率,提高早产儿进入NICU时的体温,可以作为一种有效的早产儿保暖方法,但有引起发热的风险;塑料薄膜包裹不能降低早产儿Ⅲ度或Ⅳ度脑室内出血发生率及出院前病死率。
Objective To systematically evaluate the efficacy and safety of plastic wrap for prevention of hypothermia in newborn infants.Methods We searched databases including Cochrane Library,PubMed,Scopus,CINAHL,CBM,Wanfang,VIP,and CNKI. We included all randomized controlled trials which investigated the efficacy and safety of plastic wrap on prevention of hypothermia in newborn infants. Studies were selected according to inclusion and exclusion criteria,data were extracted and study quality was appraised. RevMan 5.2 software was used to analyze the data.Results Sixteen randomized controlled trials which included 2 836 participants were included. The results of meta-analysis showed that hypothermia on admission to the NICU [RR=0.71,95%CI(0.64,0.79),P<0.01],core body temperature on admission to the NICU[MD=0.60,95%CI(0.47,0.72),P<0.01],and hyperthermia on admission to the NICU[RR=4.09,95%CI(2.12,7.88),P<0.01] in the wrapped group were significantly different with those received routine care. There was no significant difference in IVH(grades Ⅲ or Ⅳ)[RR=0.92,95%CI(0.65,1.32),P=0.66] and death during hospital stay[RR=0.75,95%CI(0.53,1.08),P=0.12] between the wrapped group and control group.Conclusion Usage of plastic wrap compared with routine care can lead to less hypothermia on admission to NICUs with higher temperature among premature infants(<28 weeks,or ≥28 weeks premature infants). Caution must be taken to avoid iatrogenic hyperthermia. Plastic wrap cannot decrease the rate of IVH(grades Ⅲ or Ⅳ) and mortality during hospital stay in premature infants.
作者
邢丽云
黄丽华
Liyun XING;Lihua HUANG
出处
《中华护理杂志》
CSCD
北大核心
2019年第3期374-379,共6页
Chinese Journal of Nursing
关键词
塑料薄膜
早产儿
低温
META分析
Plastic Wrap
Premature Infants
Hypothermia
Meta-Analysis
