先天性心脏病患儿外科矫治术后早期的体温变化规律  

Early changes in body temperature of children with congenital heart disease after surgical operation

作　　者：李淑兰[1] 吴芳琴[1] 吴瑛[1] 韩月红[2] 王艳蓉[3] 王艳玲[1] 刘淑媛[3] 田静辉[3] 王培[4] 沈怡[4] 

机构地区：[1]首都医科大学护理学院,北京100069 [2]首都医科大学附属北京安贞医院疾控处,100029 [3]首都医科大学附属北京安贞医院心外监护室,100029 [4]首都医科大学附属北京安贞医院ICU病房监护室,100029

出　　处：《中华现代护理杂志》2014年第11期1260-1264,共5页Chinese Journal of Modern Nursing

基　　金：2013年度首都护理学研究专项课题（13HL03）

摘　　要：目的：描述先天性心脏病患儿外科矫治手术后24 h内的体温变化规律、发热的发生率及发热与临床结局的关系，为临床护理提供依据。方法采用方便抽样的方法选取某三甲医院小儿心脏外科矫治手术后患儿200例，收集患儿术后24 h内体温及临床结果相关资料。结果先天性心脏病患儿外科矫治手术后3 h 体温达到高峰，之后开始缓慢下降；术后早期（术后24 h 内）发热发生率为63．5％。发热组（≥38．0℃）和正常组（＜38．0℃）两组患儿仅在主要疾病诊断方面差异具有统计学意义（χ2＝10．641，P＝0．001），其他基础资料和临床资料差异均无统计学意义（P＞0．05）。发热组和正常组患儿ICU住院时间、术后机械通气时间和住院时间中位数分别为68．50 h和46．00 h，20．00 h和16．00 h，16．00 d和12．00 d，经秩和检验比较差异均有统计学意义（ Z值分别为-1．971，-1．998，-3．700；P＜0．05）。结论先天性心脏病患儿外科矫治术后3 h体温达到高峰，超过半数的患儿会出现术后发热现象，术后发热可影响临床结局。Objective To describe the temperature variation within 24 h of the children with congenital heart disease after open heart surgery , the incidence of fever and the relation between fever and clinical outcome, aiming to provide basis for clinical nursing .Methods The convenience sampling method was used to select 200 cases of children with congenital heart disease after open heart operation , collecting body temperature within postoperative 24 hours and clinical outcomes .Results The body temperature of children reached the peak after three hours of open heart operation , then it began to slow down .The fever rate of early postoperative period （within 24 h） was 63.5%.The demographic data of fever group （≥38.0 ℃） and no fever group （〈38.0℃） had no significant difference（P〉0.05）, except for the aspect of clinical diagnosis （χ2 =10.641, P=0.001）.The median of ICU stay length, the ventilation time and the total length of hospital stay in fever group and no fever group were 68.50 h and 46.00 h, 20.00 h and 16.00 h, 16.00 d and 12.00 d, which were significantly different （Z =-1.971,-1.998,-3.700, respectively;P〈0.05）.Conclusions The body temperatures of children with congenital heart disease after open heart operation reach the peak after three hours . More than half of postoperative children will appear postoperative fever , which could affect the clinical outcome .

关 键 词：体温 心脏直视手术 先天性心脏病 

分 类 号：R473.72[医药卫生—护理学]