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題名：A Preliminary Study of Bottom Care Effects on Premature Infants' Heart Rate and Oxygen Saturation
書刊名：The Journal of Nursing Research
作者：王淯汶／張瑩如
作者(外文)：Wang, Yung-weng／Chang, Ying-ju
出版日期：2004
卷期：12:2
頁次：頁161-168
主題關鍵詞：早產兒；臀部護理；抬臀角度；心跳；血氧飽和濃度；Premature infants；Buttock care；Buttock lifting angle；Heart rate；Oxygen saturation
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
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　　　　　臀部護理是早產兒每日不可避免的護理活動且涉及不同程度抬臀姿勢，是否對早產兒生理狀態產生衝擊，少有研究探討。本研究採重複測量設計，探討 (1)臀部護理對早產兒心跳及血氧飽和濃度的影響 (2)臀部護理時不同抬臀角度對早產兒心跳及血氧飽和濃度的關係。本研究於南部某醫學中心新生兒加護病房進行。研究對象為11位早產兒，妊娠週數均 < 37週、出生天數 ( 1個月、未使用鎮靜安眠劑、無已知先天性畸形、且研究前均獲得家長簽署同意書。本研究共觀察30個臀部護理事件，分別於早產兒接受臀部護理之前10分鐘至之後15分鐘，期間每隔30秒紀錄一次心跳速率、血氧飽和濃度，並記錄臀部護理時最大抬臀角度。結果發現，臀部護理引起早產兒心跳增加與血氧飽和濃度下降超過基準值二個標準偏差者均佔63.3%，心跳減少佔30%，三者恢復到基準值的時間均超過10分鐘，且臀部護理對心跳增加、減少與血氧飽和濃度下降的幅度相較於基準值均呈有意義的差距 (p < .01)。抬臀最大角度平均為27.6 ( 9.4°，當臀部護理抬臀角度 ( 30° 時容易造成心跳增加，> 30° 時容易造成心跳減少的現象 (p = .035)。總結，臀部護理對早產兒生理的穩定度有所衝擊，護理人員應視早產兒個別性執行臀部護理且持續觀察至其生理徵象穩定，並於觀察期間給予適當的舒適護理。
　　　　　The purposes of this study were to explore (1) the effect of buttock care (BC) on premature infant heart rate (HR) and oxygen saturation (SpO2), and (2) the effect of buttock lifting angle during BCs on HR and SpO2. The study used a repeated measure design. A convenience sample of 11 premature infants in the neonatal intensive care unit (NICU) of a medical center were studied during 30 BC events. The subjects were of a gestational age of less than and 37 weeks, and postnatal age of less than one month, without known congenital abnormalities and without having been treated with sedatives during the study. Infant HR and SpO2 were measured at a 30-second interval 10 minutes before and during, and 15 minutes after BC. Maximal lifting angles of BCs during the procedure were recorded. Based on the infant's individual responses to BC, 63.3% of BCs induced an increase in HR and a decrease in SpO2, defined as the change in HR and SpO2 greater than two standard deviations from the baseline. In addition, 30% of BCs resulted in cardiac decelerations. The extent of the difference found in these change patterns in HR or SpO2 were all significant (p < .01) and their mean recovery times were longer than 10 minutes. More HR acceleration events occurred as the BC lifting angle exceeded ( 30(, and more HR deceleration events were found as the angle > 30( (p = .035).Buttock care can have a significant impact on premature infant physiological stability. The BC lifting angle may play an important role in HR acceleration or deceleration. Careful observation before and after BC for premature infants is recommended.
期刊論文
1.Barrington, K. J.、Finer, N. N.、Ryan, C. A.(1988)。Evaluation of pulse oximetry as a continuous monitoring technique in the neonatal intensive care unit。Critical Care Medicine，16(11)，1147-1153。  new window
2.Bien, M. Y.、Wang, J. H.(1988)。The effect of position on oxygenation and its clinical application。The Formosan Journal of Physical Therapy，13，78-87。  new window
3.Chen, C. M.、Tsai, T. C.(1993)。The effect of postural change on physiological functions in fullterm neonates。Tz’u-Chi Medicine Journal，5(1)，9-13。  new window
4.Chessex, P.、Reichman, B. L.、Verellen, G.、Putet, G.、Smith, J. M.、Heim, T.、Swyer, P. R.(1981)。Relation between heart rate and energy expenditure in the new bom。Pediatric Research，15(8)，1077-1082。  new window
5.Dean, E.(1985)。Effect of body position on pulmonary function。Physical Therapy，65(5)，613-618。  new window
6.Dellagrammaticas, H. D.、Kapetanakis, J.、Papadimitriou, M.、Kourakis, G.(1991)。Effect of body tilting on physiological functions in stable very low birthweight neonates。Archives of Disease in Childhood，66(4)，429-432。  new window
7.Evans, J. C.(1991)。Incidence of hypoxemia associated with caregiveing in premature infats。Neonatal Networic，10(2)，17-24。  new window
8.Fahy, B. G.、Bamas, G. M.、Nagle, S. E.、Flowers, J. L.、Njoku, M. J.、Agarwal, M.(1996)。Effects of trendelenburg and reverse trendelenburg postures on lung and chest wall mechanics。Journal of Clinical Anesthesia，8(3)，236-244。  new window
9.Fink, K. C.(1999)。The research column- Is trendelenburg a wise choice?。Journal of Emergency Nursing，25(1)，60-62。  new window
10.Fox, N. A.、Porges, S. W.(1985)。The relation between neonatal heart period patterns and developmental outcome。Child Development，56(1)，28-37。  new window
11.Gottfried, A. W.、Hodgman, J. E.、Brown, K. W.(1984)。How intensive is newborn intensive care? An environmental analysis。Pediatrics，74(2)，292-294。  new window
12.Gray, J. E.、Richardson, D. K.、McCormick, M. C.、Workman-Daniels, K.、Goldmann, D. A.(1992)。Neonatal therapeutic intervention scoring system: A therapy-based severity-of-illness index。Pediatrics，90(4)，561-567。  new window
13.Harrison, L.、Berbaum, M. L.、Stem, J. T.、Peters, K.(2001)。Use of individualized versus standard criteria to indentify abnormal levels of heart rate or oxygen saturation in preterm infants。Journal of Nursing Measurement，9(2)，181-200。  new window
14.Long, J. G.、Philip, A. G. S.、Lucey, J. F.(1980)。Excessive handling as a cause of hypoxemia。Pediatrics，65(2)，203-207。  new window
15.Norris, S.、Campbell, L. A.、Brenkert, S.(1982)。Nursing procedure and alterations in transcutaneous oxygen tension in premature infants。Nursing Research，31(6)，330-336。  new window
16.Peters, K. L.(1992)。Does routine nursing care complicate the physiologic status of premature neonate with respiratory distress syndrome?。Journal of Perinatal and Neonatal Nursing，6(2)，67-84。  new window
17.Peters, K. L.(1998)。Bathing premature infants: Physiological and behavioral consequences。American Journal of Critical Care，7(2)，90-100。  new window
18.Peters, K. L.(1999)。Infant handling in the NICU: Does developmental care make a difference? An evaluative review of the literature。Journal of Perinatal and Neonatal Nursing，13(3)，83-109。  new window
19.Pichler, G.、Schmolzer, G.、Muller, W.、Urlesberger, B.(2001)。Body position-dependent changes in cerebral hemodynamics during apnea in preterm infants。Brain & Development，23(6)，395-400。  new window
20.Porges, S. W.(1992)。Vagal tone: A physiological maker of stress vulnerability。Pediatrics，90(3)，498-504。  new window
21.Porges, S. W.(1996)。Physiological regulation in high-risk infants: A model for assessment and potential intervention。Development and Phychopathology，8(1)，43-58。  new window
22.Steven, B. J.、Johnston, C. C.(1995)。Issues of assessment of pain and discomfort in neonates。Journal of Obstetric, Gynecologic, and Neonatal Nursing，24(9)，849-855。  new window
23.Zahr, L. K.、Balian, S.(1995)。Responses of premature infants to routine nursing interventions and noise in NICU。Nursing research，44(3)，179-185。  new window
圖書論文
1.Blackburn, S.、Barnard, K.(1985)。Analysis of caregiving events relating to preterm infants in the special care unit。Infant stress under Intensive Care。Baltimore, MD：University Park Press。  new window
 
 
 
 
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