早期控制体温对治疗计划外低体温患者效果评价

蒋雯

【摘要】 目的：探讨早期应用3M患者升温系统对计划外低体温患者的临床应用效果。方法：选取本院ICU 2017年1月至2019年5月收治的计划外低体温患者40例，按照收治先后顺序分为对照组和观察组各20例。对照组给予药物及物理保暖措施，观察组早期使用3M动力充气型升温系统进行体温控制干预。对比两组体温控制情况、ICU入住天数、舒适满意度、心血管不良事件发生率。结果：干预前，两组患者体温水平比较无明显差异（P>0.05）;干预后，两组患者体温与干预前相比均有明显提升，但观察组体温提升幅度及舒适满意度评价明显优于对照组，观察组ICU入住天数、心血管不良事件发生率明显低于对照组，差异均有统计学意义（P<0.05）。结论：对ICU计划外低体温患者实施早期体温控制，可明显减少意外低体温给患者带来的危害，缩短患者ICU入住时间，提高ICU救治质量。

【关键词】 计划外低体温;早期控制;升温治疗;舒适满意度;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

生命五大體征由体温、血压、脉搏、呼吸和疼痛共同构成，保证机体新陈代谢和正常生命活动的必要条件是保持体温恒定[1]。常温状态下，正常人体表温度为37℃左右，核心体温为36.5℃～37.5℃，核心体温是指机体深部重要脏器的温度与体表温度相对应，二者之间温度梯度约为2℃～4℃[2]。体温异常可引起代谢功能紊乱甚至危及生命，ICU危重症患者由于各种原因导致机体核心体温低于36℃的现象列为计划外低体温管理，必须及早实施以医疗为目的的控制性升温干预措施[3]。既往对计划外低体温保护多限于被动保温，主动保温措施尚未普及。笔者将探讨研究本院ICU收治的术后低体温、连续肾脏替代疗法（CRRT）上机后低体温及休克低体温3类患者早期应用3M患者升温系统进行干预的临床效果。