目的:探讨降温对发热患者全身及器官局部氧代谢的影响。方法:通过采用物理降温或解热镇痛药物,监测25例危重患者体温改变前后血液动力学、氧动力学及组织局部(心脏和胃肠道)氧代谢改变。结果:体温从38.9℃±1.1℃下降到37.8℃±1.5℃后,患者循环稳定,心率和心指数(CI)显著降低,氧输送(DO_2I)和氧耗(VO_2I)显著降低,但胃粘膜pH从7.26显著升高到7.37,而且胃粘膜与动脉二氧化碳分压差(Pa-gCO_2)亦显著降低。降温前后,心脏冠状窦静脉血氧分压、血氧含量和氧摄取率均无显著改变。结论:发热患者体温降低后,CI、DO_2I、VO_2I显著降低,但组织缺氧明显改善。 Objective: To investigate the effect of cooling on the local oxygen metabolism in body and organs of fever patients. Methods: Hemodynamic, oxygen kinetics and changes of oxygen metabolism in the local and local tissues (heart and gastrointestinal tract) were monitored before and after temperature changes in 25 critically ill patients by using physical cooling or antipyretic analgesics. Results: After the body temperature decreased from 38.9 ℃ ± 1.1 ℃ to 37.8 ℃ ± 1.5 ℃, the patient’s circulatory stability, heart rate and cardiac index (CI) decreased significantly, and oxygen transport (DO_2I) and oxygen consumption (VO_2I) Significantly increased from 7.26 to 7.37, and the difference in Pa-gCO 2 between gastric mucosa and arterial pressure was also significantly reduced. Before and after cooling, the coronary sinus venous oxygen partial pressure, oxygen content and oxygen uptake rate were not significantly changed. Conclusion: The body temperature in fever decreased CI, DO_2I, VO_2I decreased significantly, but the organization hypoxia improved significantly.