合併症の少ない低出生体重児の出生体重からみた入院日数予測 <原著>

低出生体重児の入院期間の予測は,母親をはじめ家族に安心感をもたらすとともに,治療・ケア計画に役立ち,評価や業務改善につながるという前提のもとに,入院時点に最も確実に把握可能な出生体重及び在胎日数を変数として入院日数との関係を統計分析し,入院日数の予測が可能かどうかを検討した.沖縄県のNICUを有する国公立の2病院において,生後0～3日以内にNICUに入院した2500g未満の入院児それぞれ209人,295人について入院期間,出生週数,出生体重を調べその統計分析を試みた。その結果,低出生体重児の出生体重と入院期間には高い有意の相関があり,それは在胎日数と入院期間の関係より高い相関であった.また直線式より指数式によく当てはまった.このことは出生体重を,指数式に当てはめることで入院期間をある程度,推測することが可能であることを示唆している.このことから各施設のNICUの低体出生東児の入院日数は,児の出生体重と入院期間のデータから指数式の係数を求めて曲線式に当てはめ一覧表を作成することで予測できると考える.看護者はこの一覧表と照らし合わせることで,早産で生まれた合併症の少ない児に対しては,出生体重のみから入院早期に,ある程度の入院日数を予測することができる.その入院予測日数を基に退院予定日からさかのぼってケア計画を立てることができ,母親や家族の不安軽減や,退院準備に役立てるとともに看護ケアの評価にも活用できると考える.

Predicting the hospitalization period for low-birth-weight infants is may help the infant's mother and other family members reduce their anxiety, and to be useful in devising a treatment and care plan, leading to better evaluation of care. Under this expectation, this study was undertaken to statistically analyze the relationship of hospitalization period to two variables (birth weight and intrauterine period expressed in days) , because the data are most reliably available at the time of admission to NICU. At 2 hospitals in Okinawa Prefecture (a national hospital and a public hospital) , data on hospital stay period, gestational age at birth (the intrauterine period) and birth weight were collected from 211 and 297 infants who were admitted to the NICU of these two hospitals within 0-3 days after birth with a weight less than 2500 g. The statistically significant correlation was noted between the birth weight and the hospitalization period of low-birth-weight infants, and its correlation was higher than the gestational age at birth. We obtained exponential regression curve formula respectively. The formula were Y1=316.452 × e-0.0017 × W and Y2=288.791 × e-0.0012 × W, where e is the base on Nepierian logarithms ;2.718 and W is birth weight. The hospitalization period of low-birth-weight infant was born without major complications can be predicted from a table that is prepared by applying to these formulas. By comparing the birth weight of a given infant to this table, the nurse can predict the hospitalization period of the infant relatively accurately soon after admission on the basis of birth weight alone. If the hospitalization period can be predicted in this way, the medical staff can devise a treatment and care plan towards the predicted discharge day. The predicted stay period can also be utilized to alleviate the anxiety of the infant's mother and other family members and to allow the infant's family to prepare for discharge. Furthermore, the predicted hospitalization period may also be utilized for ...