早产儿初始管理黄金时段方案的实施：一项质量改进研究
Implementation of a Golden Hour protocol for initial management of preterm infants: a quality improvement study.
摘要(中文译文)
本研究实施并评估了一种针对胎龄<31周和/或估计胎儿体重（EFW）<1300 g的早产儿生后第一小时管理的系统化方法。主要关注组织效率、体温调节和低血糖预防，次要评估临床结局和团队认知。于2022年1月至2023年7月在一家三级新生儿重症监护病房（NICU）开展了一项前瞻性观察性研究。符合纳入标准的婴儿与2019年回顾性对照队列进行比较。黄金一小时（GH）方案强调预见性、角色分配和早期干预，包括脐静脉置管（UVC）和肠外营养（PN）的启动。结局指标包括操作指标（如暖箱关闭时间、UVC置管时间）和临床结局（如低体温、低血糖、死亡率及早产儿主要并发症）。通过问卷调查评估团队认知。GH组纳入77名婴儿，回顾性对照组纳入72名婴儿。GH组婴儿低体温发生率较低（23/77 vs. 36/72，= 0.03），首次血糖评估时间显著更早[43（35-50）vs. 63（53-77）分钟，< 0.001]。暖箱关闭时间中位数为64（58-71）分钟，接近GH方案60分钟的目标。两组间低血糖发生率、死亡率和早产儿主要并发症（如支气管肺发育不良、坏死性小肠结肠炎）发生率相似。方案实施后，团队成员报告预见性、沟通和工作满意度均有所改善。GH方案改善了体温调节和团队效率，未改变临床结局。其对团队协作的积极影响支持在更大规模研究中进一步评估。
Abstract
This study implemented and evaluated a systematic approach for managing preterm infants <31 weeks of gestational age (wGA) and/or estimated fetal weight (EFW)<1300 g during their first hour of life. The primary focus was organizational efficiency, thermal regulation, and hypoglycemia prevention, with secondary assessment of clinical outcomes and team perception. A prospective observational study was conducted from January 2022 to July 2023 in a tertiary neonatal intensive care unit (NICU). Infants meeting inclusion criteria were compared with a retrospective 2019 control cohort. The Golden Hour (GH) protocol emphasized anticipation, role assignment, and early interventions, including umbilical venous catheterization (UVC), and parenteral nutrition (PN) initiation. Outcomes included procedural metrics (e.g., time to incubator closure, UVC placement) and clinical outcomes (e.g., hypothermia, hypoglycemia, mortality, and major comorbidities of prematurity). Team perception was assessed via survey. 77 infants were included in the GH group and 72 infants in a retrospective control group. GH infants experienced less hypothermia (23/77 vs. 36/72 - = 0.03) and first blood glycemia evaluation was significantly earlier [43 (35-50) vs. 63 (53-77) min - < 0.001]. The median incubator closure time was 64 (58-71) min, close to the GH target of 60 min. Rates of hypoglycemia, mortality, and major comorbidities of prematurity (e.g., bronchopulmonary dysplasia, necrotizing enterocolitis) were similar between groups. Team members reported improved anticipation, communication, and job satisfaction following protocol implementation. The GH protocol improved thermal regulation and team efficiency without altering clinical outcomes. Its positive effect on teamwork supports further evaluation in larger studies.
如何引用
AMA
Sarah Dénes, Estelle Stockis, Vincent Rigo, Sophie Tribolet. Implementation of a Golden Hour protocol for initial management of preterm infants: a quality improvement study.. Frontiers in pediatrics. 2026; doi:10.3389/fped.2026.1832031.
APA
Sarah Dénes, Estelle Stockis, Vincent Rigo, Sophie Tribolet (2026). Implementation of a Golden Hour protocol for initial management of preterm infants: a quality improvement study.. Frontiers in pediatrics. https://doi.org/10.3389/fped.2026.1832031
GB/T 7714
Sarah Dénes, Estelle Stockis, Vincent Rigo, Sophie Tribolet. Implementation of a Golden Hour protocol for initial management of preterm infants: a quality improvement study.[J]. Frontiers in pediatrics, 2026 doi:10.3389/fped.2026.1832031.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出