重度烧伤患者核心温度的监测

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目的比较重度烧伤患者不同核心温度监测方法的体温差异。方法选择ICU治疗的特重度烧伤患者15例。进行多人次的血温、膀胱温度和肛温监测;分析相关因素对体温测定结果的影响。结果无红外烧伤治疗机治疗时,血温/膀胱温度组(11人次)为(38.6±0.3)℃/(38.6±0.3)℃;膀胱/肛温组(11人次)为(39.0±0.6)℃/(39.0±0.7)℃。有红外烧伤治疗机治疗时,血温/膀胱温度组(25人次)为(38.6±0.3)℃/(38.4±0.4)℃;膀胱/肛温组(37人次)为(38.8±0.3)℃/(38.8±0.3)℃。结果显示,不论有无红外线烧伤治疗机治疗,血温/膀胱温度和膀胱温度/肛温度相比均无统计学差异(P>0.05)。单因素相关分析显示,血温/膀胱温度呈显著正相关(r=0.829,P<0.05),膀胱温度/肛温亦呈显著正相关(r=0.948,P<0.01);血温/膀胱温度与年龄、性别、烧伤面积、APACHEⅡ评分和是否应用烤灯无明显相关性(P>0.05)。腹泻和大便期间与肛温/膀胱温度呈显著负相关(r=-0.570和r=-0.700,P<0.01),尿量与其温差间无明显相关性(P>0.05)。结论对于重度烧伤患者,血温、肛温和膀胱温度都能准确反映患者的核心温度。尿量对膀胱温度监测结果无明显影响。腹泻和大便明显影响肛温监测结果。 Objective To compare body temperature differences between different core temperature monitoring methods in patients with severe burn. Methods 15 patients with severe burn in ICU were selected. Multi-person blood temperature, bladder temperature and rectal temperature monitoring; analysis of relevant factors on the body temperature measurement results. Results The blood temperature / bladder temperature group (11 persons) was (38.6 ± 0.3) ℃ / (38.6 ± 0.3) ℃ and the bladder / rectal temperature group (11 persons) was (39.0 ± 0.6) ℃ /(39.0 ± 0.7) ° C. In the treatment with infrared burn machine, the blood temperature / bladder temperature group was (38.6 ± 0.3) ℃ / (38.4 ± 0.4) ℃ and that in the bladder / rectal temperature group (37) was (38.8 ± 0.3) ℃ / (38.8 ± 0.3) ° C. The results showed no significant difference (P> 0.05) between blood temperature / bladder temperature and bladder temperature / rectal temperature, irrespective of the treatment with infrared burn machine. Univariate correlation analysis showed that there was a significant positive correlation between blood temperature and bladder temperature (r = 0.829, P <0.05) and bladder / rectal temperature (r = 0.948, P <0.01) There was no significant correlation between age, sex, area of ​​burns, APACHEⅡscore and whether the lamp was used or not (P> 0.05). There was a significant negative correlation between rectal temperature and bladder temperature during diarrhea and stool (r = -0.570 and r = -0.700, P <0.01). There was no significant correlation between urine output and temperature (P> 0.05). Conclusion For patients with severe burn, blood temperature, rectal temperature and bladder temperature can accurately reflect the patient’s core temperature. Urine output had no significant effect on bladder temperature monitoring. Diarrhea and stool significantly affect rectal temperature monitoring results.
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