| Objective: To explore the effect of hypothermia on preterm infants and their complications by analyzing the admission temperature and clinical data of preterm infants with gestational age < 32 weeks,so as to provide reference for clinical management of preterm infants.Methods: In this retrospective study,225 premature infants with gestational age <32weeks who were born in the Department of Obstetrics of Linyi Central Hospital from January 1,2020 to December 31,2020 were selected as the subjects.Preterm infants were divided into mild hypothermia(36-36.4℃)group(n=78),moderate hypothermia(35-35.9℃)group(n=70)and normal body temperature(36.5-37.5℃)group(n=77)according to their admission temperature.The preterm infants in the three groups were collected for blood routine test,liver function,renal function,electrolyte,myocardial enzyme,neuron specific enolase(NSE),blood gas analysis and coagulation routine at 1,3and 7 days after birth.The incidence and outcome of complications of hypoglycemia,hyperbilirubinemia,intracranial hemorrhage,respiratory distress syndrome,pulmonary hemorrhage,patent ductus arteriosus,sepsis,necrotizing enterocolitis,and acute renal failure were observed during hospitalization.The above clinical data were statistically analyzed.Results:1.The incidence of admission hypothermia in preterm infants was 65.78%(148/225),of which the incidence of mild hypothermia was 34.67%(78/225),and the incidence of moderate hypothermia was 31.11%(70/225).There were no cases of severe hypothermia.There were statistically significant differences in birth weight,gestational age,postnatal time,1 min and 5 min Apgar scores among normal body temperature group,mild hypothermia group and moderate hypothermia group(P<0.05).There were no significant differences in delivery mode,number of pregnancies,maternal complications,fetal sex and delivery room temperature among the three groups(P>0.05).2.There were significant differences among the three groups in peripheral blood leukocyte,neutrophil percentage,platelet count,serum total bilirubin,indirect bilirubin,blood glucose,CK,CK-MB and NSE levels,blood coagulation indexes APTT,Pt,TT,D-dimer,FIB,blood gas indexes p H,Pa O2,Pa CO2,BE and lactic acid at 1 and 3 days after birth(P <0.05).The creatinine and urea nitrogen in mild and moderate hypothermia groups were higher than those in normal body temperature group,and the difference was statistically significant(P<0.05).3.Comparison of premature complications between mild hypothermia group,moderate hypothermia group and normal hypothermia group,the incidence of hypoglycemia was[14/78(17.9%),17/70(24.3%)),8/77(10.4%)),hyperbilirubinemia was [13/78(16.7%),19/70(27.1%),8/77(10.4%)],intracranial hemorrhage was [8/78;10.3%),(12/70;17.1%),(3/77;3.9%)],respiratory distress syndrome was [(55/78;70.5%),(54/70;82.9%),(46/77;59.7%)],pulmonary hemorrhage was [(6/78;7.7%),(9/70;10.3%),(12/70;17.1%),(3/77;3.9%)],pulmonary hemorrhage was [(6/78;7.7%),(9/70);12.9%),(2/77;2.6%)].There were statistically significant differences among the three groups(P<0.05).The incidence of patent ductus arteriosus was [(11/78;14.1%),(12/70;17.1%),(10/77;13.0%)],septicemia was [(3/78;3.8%),(7/70;10.0%),(1/77;1.3%)],necrotizing microenteritis was [1/78;1.3%),(2/70;2.9%),(0/77)],and acute renal failure was [2/78;2.6%),(3/70;4.3%),(0/77)].There was no significant difference among the three groups(P>0.05).In moderate hypothermia group,2 premature infants died,the mortality was0.9%.Conclusions:1.Low birth weight,small gestational age,low Apgar score at 1 min and 5 min,and late admission are the high risk factors for hypothermia in premature infants with gestational age <32 weeks.2.Hypothermia in preterm infants can cause abnormal blood routine,blood glucose,bilirubin,renal function,coagulation function and blood gas analysis indicators,and can lead to increased incidence of hypoglycemia,hyperbilirubinemia,intracranial hemorrhage,respiratory distress syndrome and pulmonary hemorrhage.The lower the body temperature,the greater the impact. |
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