五種新生兒體溫測量方式之探討

Investigating Relationships Among Five Temperature Measurement Sites in Newborns

李宜謙(Yi-Chien Lee) ； 劉介宇(Chieh-Yu Liu) ； 林嘉琪(Chia-Chi Lin) ； 吳維紋(Wei-Wen Wu)

《護理雜誌》 60卷2期 (2013/04) Pp. 41-49

https://doi.org/10.6224/JN.60.2.41

摘要

背景：由於新生兒體溫控制中樞尚未發育成熟，身體溫度容易受到環境變化而改變，監測新生兒體溫變化能即時因應，避免因體溫過高或過低產生身體傷害。肛溫為最佳測得核心溫度的方式，然而將體溫計插入肛門的測量方式會對新生兒造成不適感以及危險性，目前臨床上不再採用肛溫測量作為常規體溫測量方式，雖已改為測量腋溫、耳溫、或是背溫，但尚缺乏藉由各種體溫測量方式反應出新生兒的身體核心溫度之研究結果。電子體溫計有使用上之便利性，已全面取代了傳統水銀溫度計，然而過去新生兒體溫測量的相關研究均採用水銀溫度計進行測量，利用電子體溫計作為收集資料的工具相關研究仍付之闕如。目的：探討利用電子體溫計測量新生兒五個部位（腋溫、背溫、左耳溫、右耳溫、肛溫）體溫之關係，並了解性別差異、環境溫度等影響因素。方法：本研究為描述性相關研究設計，採方便取樣，收案期間為2010年8月至2011年2月，收案地點於台北市某立案之產後護理之家，共取樣33名出生1至28天嬰兒。每位新生兒以MT-200電子體溫計測量背溫、腋溫及肛溫、IRT4520耳溫槍測量耳溫，以SPSS18.0 for Windows版本統計軟體進行描述性統計、皮爾森相關、廣義估計模式、以及組內相關係數等資料統計分析。結果：本研究中發現右耳溫與肛溫之差異性最低，且左耳溫與肛溫具有顯著相關；腋溫穩定性最高且無離群值產生。另外，不同性別之新生兒體溫並無差異性；不論是上午或是下午進行體溫測量時，五個部位體溫測量結果均呈現低度相關。結論／實務應用：耳溫可用於取代肛溫，做為臨床護理人員以及父母於測量新生兒體溫時之參考。

關鍵字

足月兒 ； 體溫 ； 耳溫 ； 電子體溫計

並列摘要

Background: Environmental conditions can easily affect the body temperature of newborns because their central nervous system, which helps maintain body temperature, has not yet fully developed. Monitoring changes in newborn body temperature can help prevent harm caused by abnormally high and low body temperatures. Taking rectal temperature readings is the most reliable way to obtain core temperature. However, because inserting a thermometer into a newborn's rectum may cause discomfort and present health risks, this temperature-taking approach is no longer used in clinical settings. The axillary temperature readings now used, including ear and back temperature, have not been empirically verified to accurately reflect core body temperature. Convenient-to-use electronic thermometers have replaced traditional mercury thermometers in the clinic. However, nearly all research done until recent years has employed mercury thermometers for temperature measurement, there is a paucity of research employing electronic thermometers.Purpose: The purpose of this study was to investigate relationships among five temperature measurement sites (including tympanic temperature, rectal temperature, axillary temperature, and back temperature) in newborns.Method: This study used a descriptive-correlation design, employed convenience sampling, and collected data from August 2010 to February 2011 at a registered postpartum nursing home in Taipei. Thirty-three babies aged from 1 to 28 days old were recruited. MT-200 electronic thermometers were utilized to take back, axillary, and rectal temperature readings and an IRT4520 ear thermometer was used to take ear temperature readings. Collected data were analyzed using SPSS18.0 statistical software for descriptive statistics, Pearson correlation, generalized estimation equations (GEE), and intraclass correlation coefficient (ICC).Results: We identified the least difference between right tympanic temperature and rectal temperature' a significant relationship between left tympanic temperature and rectal temperature, and axillary temperature as the most stable of the 5 body-temperature reading methods, with no outliers. There were no gender differences among the five body temperatures. Results revealed the ICC of the five temperature measurement sites to be low during both morning and evening measurements.Conclusions / Implications for Practice: Current research suggests that tympanic temperature can replace rectal temperature readings. Findings may provide a reference to clinical nursing staffs and parents to measure newborn body temperature.

並列關鍵字

full-term baby ； body temperature ； tympanic temperature ； electronic thermometer

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