| Objective: To observe the improvement of thermal insulation measures in newborns after the first hour(Golden Hour)has been used for comprehensive improvement before and immediately after birth.Effects on the hospitalization temperature,morbidity and mortality of postpartum and preterm infants.Methods:1.All the cases in this trial were randomly selected from January 1,2014 to December 31,2018.All the fullterm children and premature infants born in this hospital and transferred to the Neonatal Intensive Care Unit(NICU)in our hospital within 1 hour after birth.From January 1,2014 to June 30,2016,100 cases of fullterm and premature infants born in our hospital under the original simple thermal insulation measures are defined as control groups.From July 1,2016 to December 31,2018,after the improvement of thermal insulation measures in our hospital,100 cases of fullterm and premature infants born under comprehensive and effective thermal insulation methods were defined as intervention groups.2.A comparative study was carried out on 100 fullterm children in the control group and 100 fullterm infants in the intervention group after the improved insulation.A comparative study was conducted between 100 premature infants in control group and 100 premature infants in intervention group after improved thermal insulation.3.Statistics and comparison between the two groups before and after the implementation of comprehensive and effective thermal insulation measures in the monthly and premature infants admitted to hospital temperature and various system morbidity and mortality changes.Results:1.Comparison of body temperature in the control group and the intervention group:the incidence of hypothermia was significantly lower than that of the control group after comprehensive improvement of thermal insulation measures(95 % vs 37 % of fullterm children;98 % vs.49 % of premature infants),statistically significant(P<0.05);The specific body temperature distribution of the two groups is as follows:Fullterm infants group: body temperature at the time of admission is 35 °C(22 % vs5 %),35 to 35.9 °C(35 % vs 10 %),36.0 °C to 36.4 °C(28 % vs 22 %),36.5 °C ～37.5 °C(5 % vs 63 %),<37.5 °C(0 % vs 0 %);Premature infants: body temperature at admission is 35 °C(48 % vs 9 %),35 ～ 35.9 °C(33 % vs 13%),36 °C ～ 36.4 °C(17 %vs 27 %),36 °C ～ 36.4 °C(2 % vs 51 %);> 37.5℃(0 % vs 0 %).2.Compared with the control group,the full-term infants’ oxygen demand,neonatal wet lung,hypoglycemia,1-minute and 5-minute Apgar score < 7,Metabolic acidosis were significantly lower than those of the control group,the difference was statistically significant(p<0.05).However,bradycardia,neonatal aspiration pneumonia,respiratory failure,RDS,feeding intolerance,gastrointestinal bleeding,delayed faecal excretion,Thrombocytopenia,neonatal hypoxic ischemic encephalopathy,intracranial hemorrhage,Polycythemia,electrolyte disturbance,although the incidence rate decreased,there was no statistical difference in this study(p>0.05).In the comparison of Neonatal Scleredema,pulmonary hemorrhage,neonatal necrotizing enterocolitis,Septicemia,because the incidence of both groups is too low,the number of cases can not be compared statistically,there is no statistical difference.3.There were significant differences in the incidence of oxygen demand,wet lung,apnea and other diseases in premature infants(p < 0.05),and in the digestive system,the incidence of respiratory system in premature infants was higher than that in normal infants(p<0.05),for example,the incidence of feeding intolerance,gastrointestinal bleeding,delayed defecation,and duration of parenteral nutrition also showed significant difference(p<0.05)There were also significant differences in Heart Rate,Blood Glucose,coagulation,Metabolic acidosis,Apgar<7,hyperbilirubinemia and neonatal stunting(p<0.05),although the incidence of aspiration pneumonia,aspiration failure,intracranial hemorrhage,electrolyte disturbance,Thrombocytopenia,Polycythemia and Septicemia in the intervention group was lower than that in the control group,however,no statistical differences were found in this study.No cases of necrotizing enterocolitis,kidney failure or pulmonary hemorrhage were found in both groups.It’s impossible to make a statistical comparison.4.In the control group,it was found that the body temperature of all the full-term infants with above statistical significance was mainly distributed in < 35 °c state,andthere were statistical differences between the groups of <35 °C and >35 °c(p < 0.05).In the control group,the temperature at admission of all the premature infants with statistical significance was also less than 35 °C.And there were statistical differences between the temperature groups with < 35 °C and that with > 35 °c(p < 0.05).Conclusion: After birth,under the comprehensive effective heat preservation measures,it can effectively reduce the incidence of hypothermia in full-term infants and premature infants,and at the same time,it can reduce the incidence of various systems in full-term infants and premature infants to different degrees,there were statistical differences in the incidence of multiple systemic diseases,especially in preterm infants.Most of the cases with statistical difference in incidence rate occurred in the temperature state of admission less than 35 °C.It is necessary to carry out comprehensive and effective insulation for Newborns,especially premature infants,especially to improve the hypothermic state of admission below 35 °C,so as to reduce the incidence of the disease. |
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