早期控制體溫對(duì)治療計(jì)劃外低體溫患者效果評(píng)價(jià)

蔣雯

【摘要】 目的：探討早期應(yīng)用3M患者升溫系統(tǒng)對(duì)計(jì)劃外低體溫患者的臨床應(yīng)用效果。方法：選取本院ICU 2017年1月至2019年5月收治的計(jì)劃外低體溫患者40例，按照收治先后順序分為對(duì)照組和觀察組各20例。對(duì)照組給予藥物及物理保暖措施，觀察組早期使用3M動(dòng)力充氣型升溫系統(tǒng)進(jìn)行體溫控制干預(yù)。對(duì)比兩組體溫控制情況、ICU入住天數(shù)、舒適滿(mǎn)意度、心血管不良事件發(fā)生率。結(jié)果：干預(yù)前，兩組患者體溫水平比較無(wú)明顯差異（P>0.05）;干預(yù)后，兩組患者體溫與干預(yù)前相比均有明顯提升，但觀察組體溫提升幅度及舒適滿(mǎn)意度評(píng)價(jià)明顯優(yōu)于對(duì)照組，觀察組ICU入住天數(shù)、心血管不良事件發(fā)生率明顯低于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：對(duì)ICU計(jì)劃外低體溫患者實(shí)施早期體溫控制，可明顯減少意外低體溫給患者帶來(lái)的危害，縮短患者ICU入住時(shí)間，提高ICU救治質(zhì)量。

【關(guān)鍵詞】 計(jì)劃外低體溫;早期控制;升溫治療;舒適滿(mǎn)意度;不良事件

Effect of early control of body temperature on patients with planned low body temperature

Jiang Wen

Department of Critical Care Medicine， Yangzhou Affiliated Hospital， NanjingUniversity of Traditional Chinese Medicine， Yangzhou， Jiangsu 225000

[Abstract] Objective：To explore the clinical application effect of early application of 3M patient warming system to patients with unplanned hypothermia. Methods： Forty patients with unplanned hypothermia admitted to our hospital from January 2017 to May 2019 were divided into control group and observation group according to the order of treatment. The control group was given the application of drugs and physical warming measures. The observation group used the 3M dynamic inflation type heating system for body temperature control intervention. Compare the two groups of body temperature control， ICU stay days， comfort satisfaction， and the incidence of cardiovascular adverse events. Results： Before the intervention， there was no significant difference in body temperature between the two groups （P>0.05）. After the intervention， the body temperature of both groups was significantly higher than that before the intervention， but the evaluation of the temperature increase and comfort satisfaction of the observation group was significantly better than that of the control group. The incidence of ICU stay and cardiovascular adverse events in the observation group was significantly lower than that in the control group; the difference was statistically significant （P<0.05）. Conclusion： Early temperature control of patients with ICU unplanned hypothermia can significantly reduce the risk of accidental hypothermia to patients， shorten the ICU stay， and improve the quality of ICU treatment.

[Key words]Unplanned hypothermia;Early control;Warming therapy;Comfort satisfaction;Adverse events

生命五大體征由體溫、血壓、脈搏、呼吸和疼痛共同構(gòu)成，保證機(jī)體新陳代謝和正常生命活動(dòng)的必要條件是保持體溫恒定[1]。常溫狀態(tài)下，正常人體表溫度為37℃左右，核心體溫為36.5℃～37.5℃，核心體溫是指機(jī)體深部重要臟器的溫度與體表溫度相對(duì)應(yīng)，二者之間溫度梯度約為2℃～4℃[2]。體溫異常可引起代謝功能紊亂甚至危及生命，ICU危重癥患者由于各種原因?qū)е聶C(jī)體核心體溫低于36℃的現(xiàn)象列為計(jì)劃外低體溫管理，必須及早實(shí)施以醫(yī)療為目的的控制性升溫干預(yù)措施[3]。既往對(duì)計(jì)劃外低體溫保護(hù)多限于被動(dòng)保溫，主動(dòng)保溫措施尚未普及。筆者將探討研究本院ICU收治的術(shù)后低體溫、連續(xù)腎臟替代療法（CRRT）上機(jī)后低體溫及休克低體溫3類(lèi)患者早期應(yīng)用3M患者升溫系統(tǒng)進(jìn)行干預(yù)的臨床效果。