極低出生体重児の脱毛の発生誘因 <原著>

極低出生体重児にみられる頭部の脱毛はケアの工夫で予防あるいは軽減することができるのではないかと考え、脱毛の発生に関する実態を調査した。対象はNICUに入院した極低出生体重児30名、在胎24～32週、出生体重568～1364gとし、入院時から脱毛の有無を経時的に観察記録した。結果:1.出生体重の少ない児に脱毛する傾向があったが、出生体重と脱毛との関係は認められなかった。2.気管内挿管の有無と脱毛には関係が認められたが、挿管日数とは比例しなかった。3.頭部に円座を使用した有無と脱毛には関係が認められた。4.体位は仰臥位とその他との比較では関係が認められた。5.中心静脈カテーテル(臍カテーテル)の挿入の有無と脱毛は関係が認められた。結論として、気管内挿管や中心静脈カテーテル挿入などによる同一体位や体位制限が頭部を圧迫し脱毛に影響していた。円座使用により円座の接する同一部位が圧迫により、その部位に脱毛を発生させていた。研究の限界としてストレスや出生後の循環動態など個々の全身状態まで検討できなかった。

The occurrence of alopecia was surveyed to devise some care technique which may prevent or reduce scalp hair loss seen in Very low birth weight infants. The subjects were 30 Very low birth weight infants admitted to the NICU, with 24-32 weeks gestation and birth weight 568-1364 g. Occurrence of alopecia was observed and recorded chronologically from time of admittance. Results. 1) Although low birth weight infants showed tendency for hair loss. no relationship was observed between birth weight and hair loss. 2) Although a relationship was observed between endotracheal intubation and hair loss. there was no correlation to the number of days of intubation. 3) A relationship was observed between the use of donut-shaped cushion for the head and hair loss. 4) For body position, a relationship was observed between supine position. in comparison to other positions, and hair loss. 5) A relationship was observed between the insertion of central venous catheter (umbilical catheter) and hair loss. In summary. constant or restrained body position due to endotracheal intubation or central venous catheter compressed the scalp and contributed to hair loss. By using donut-shaped cushion, the part that constantly contacted the cushion was compressed and hair loss occurred in that area. As limitation of this study, we were unable to investigate the individual systematic conditions such as stress or circulatory dynamics after birth.