颅脑外伤患者尿流量变化与膀胱温关系的临床研究  

A clinical study on the relationship between changes of urine flow and bladder temperature in patients with craniocerebral trauma

作　　者：仲悦萍[1] 陆凤英[1] 陈晓艳[2] 张晓梅[2] 曹玲[2] 陈颖曦[2] 王冬[3] 孙琴[2] 吴小波[2] ZHONG Yueping;LU Fengying;CHEN Xiaoyan;ZHANG Xiaomei;CAO Ling;CHEN Yingxi;WANG Dong;SUN Qin;WU Xiaobo(Department of Surgery,the Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China;Department of Neurosurgery ICU,the Affiliated Hospital of Nantong University;Department of Burn,the Affiliated Hospital of Nantong University)

机构地区：[1]南通大学附属医院外科,江苏南通226001 [2]南通大学附属医院神经外科ICU [3]南通大学附属医院烧伤科

出　　处：《徐州医科大学学报》2018年第8期550-553,共4页Journal of Xuzhou Medical University

基　　金：南通市科技局2016N-关键技术研究-农业与社会发展-新型临床诊疗技术攻关项目（MS22016017）

摘　　要：目的探究尿流量与膀胱温检测变量对颅脑外伤患者的临床诊疗价值，为颅脑外伤患者体温的科学监测提供参考依据。方法选取在我院神经外科ICU治疗的颅脑外伤患者共80例，根据治疗方案分为研究组和对照组，每组各40例。研究组给予复方甘露醇治疗，对照组给予普通补液，比较2组患者颅内压及平均动脉压变化情况。按照实验设计分别检测2组尿流量、膀胱温、直肠温，并分析不同尿流量与膀胱温、直肠温之间的相关性及一致性。结果研究组颅内压降低幅度[（17．24±3．15）mmHg]显著高于对照组[（5．14±1．64）mmHg]，差异有统计学意义（P〈0．05）。研究组平均动脉压降低程度（（31．43±5．36）mmHg]显著高于对照组[（2．45±0．81）mmHg]，差异有统计学意义（P〈0．05）。研究组每小时尿流量[（52．26±10．14）ml]显著高于对照组[（23．15±6．26）ml]，差异有统计学意义（P〈0．05）。2组患者直肠温均与膀胱温相当，差异无统计学意义（P〉0．05），直肠温与腋温相比，差异有统计学意义（P〈0．05）。Pearson分析显示不同尿流量时，膀胱温均与直肠温呈正相关，差异有统计学意义（r=3．125，P〈0．05）；Bland—Altman分析显示膀胱温与直肠温的一致性较好，且不受尿流量的影响。结论采用测温导尿管检测膀胱温度，不受尿流量影响，能较好反映颅脑外伤患者体温和病情，有较高的临床诊断价值，值得临床推广应用。Objective To explore the clinical value of urine flow and bladder temperature detection in patients with craniocerebral trauma, and to provide evidence for scientific monitoring of body temperature in patients with craniocerebral trauma. Methods A total of 80 patients with craniocerebral trauma who were treated in our department were selected. They were divided into a study group and a control group according to treatment regimens （ n = 40 each）. The study group was treated with compound mannitol, while the control was group given general rehydration. Both groups were compared for intracranial pressure and mean arterial pressure changes. According to the experimental design, their urine flow, bladder temperature, rectal temperature were detected, the relationship between different urine flow and bladder temperature, rectal temperature was analyzed. Results The study group showed significantly greater changes in intracranial pressure [ （ 17.24±3.15 ） mmHg ] and the mean arterial pressure [ （ 31.43±5.36 ） mmHg ], compared with the control [ （5.14±1.64） mmHg] and[ （2.45±0.81 ） mmHg] （ each P 〈 0.05 ）. The urine flow in the study group [ （52.26 ±10.14） ml] was significantly higher than that in the control group [ （23.15 ± 6.26） ml] （P 〈 0.05 ）. There was no significant difference in rectal and bladder temperatures between the two groups （ P 〉 0.05 ）. However, statistical difference was found between rectal axillary temperatures in the two groups （ P 〈 0.05 ）. According to Pearson analysis, the bladder temperature was positively associated with the rectal temperature at different urinary flow （ r = 3. 125, P 〈 0. 05 ）. Bland - Ahman analysis showed that the bladder temperature was consistent with rectal temperature, without influence of urinary flow. Conclusions The bladder temperature when measured by a temperature measurement catheter can not be affected by the urine flow. It can reflect the body temperature and the condition of traumatic brain injury.

关 键 词：尿流量 膀胱温 颅脑外伤 直肠温 

分 类 号：R651[医药卫生—外科学]