改良医用降温毯在重症患者降温治疗中的效果评价  

Effect evaluation of modified medical cooling blanket in hypothermia therapy of critically ill patients

作　　者：张茹 黄晓萍[2] 肖银娟 李春雨 纪志峰 羊玥祺 赵鹏程 ZHANG Ru;HUANG Xiaoping;XIAO Yinjuan;LI Chunyu;JI Zhifeng;YANG Yueqi;ZHAO Pengcheng(Intensive Care Unit of Maternal and Child Branch,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029;Nursing Department,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029;Clinical Medical Engineering of Maternal and Child Branch,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029)

机构地区：[1]南京医科大学第一附属医院妇幼分院重症医学科,江苏南京210029 [2]南京医科大学第一附属医院护理部,江苏南京210029 [3]南京医科大学第一附属医院妇幼分院临床医学工程处,江苏南京210029

出　　处：《实用临床医药杂志》2023年第8期31-35,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省医院协会医院管理创新研究重点课题(JSYGY-2-2020-695)。

摘　　要：目的观察使用膀胱测温代替直肠测温控制医用降温毯启动和停止的效果。方法在医用降温毯中加装适配测温尿管,将测温尿管监测的膀胱温信号传输至降温毯,替代直接测量的肛温探头控制启停。将改良后的降温毯与计量专用测温仪进行数据校准。选取高热重症患者32例为研究对象,应用改进后的降温毯行降温治疗;每4 h观察并记录膀胱温和直肠温,分析膀胱温和直肠温在重症患者降温监测中的一致性;进一步分析护士在使用改良降温毯前后执行安全降温的正确率。结果改良后的降温毯与计量专用测温仪测得的温度差异无统计学意义(P>0.05);改良降温毯测得的膀胱温与水银温度计直接测得的直肠温呈高度正相关(r=0.99,P<0.05),在95%一致性界限范围内二者差值的绝对值最大为0.16℃,平均差值为0.01℃,具有高度一致性;护士因测量部位选择不正确造成降温毯温控启停信号错误的发生率为0。结论改良降温毯能够通过膀胱测温替代直肠温,准确地为重症患者执行降温治疗,保证患者舒适度的同时,提升了护士执行降温毯操作的正确性和安全性。Objective To observe the efficacy of bladder temperature measurement instead of rectal temperature measurement in controlling the start and stop of medical cooling blankets.Methods An adaptive thermometric catheter was installed in the medical cooling blanket,the bladder temperature signal monitored by the thermometric catheter was transmitted to the cooling blanket,in order to control the start and stopfunctions by replacing the probe for direct measurement of anal temperature.The data of the modified cooling blanket was calibrated with special measuring thermometer.A total of 32 critically ill patients with high fever were selected as the research objects,and they were conducted with hypothermia therapy by using the modified cooling blanket;bladder temperature and rectal temperature were observed and recorded every 4 hours,and the consistency of bladder temperature and rectal temperature in monitoring hypothermia of critically ill patients was analyzed;the accuracy of performing safe cooling by nurses before and after application of the modified cooling blanket was further analyzed.Results There was no significant difference in the measured temperature between the modified cooling blanket and the special thermometer(P>0.05);there was a high positive correlation between bladder temperature measured by modified cooling blanket and rectal temperature directly measured by mercury thermometer(r=0.99,P<0.05),and within the 95%consistency limit,the absolute value of the difference between the two methods was 0.16℃,with an average difference of 0.01℃,indicating a high consistency;the incidence of start-stop signal error of temperature control for cooling blanket due to the incorrect selection of measurement site by nurses was 0.Conclusion The modified cooling blanket can replace rectal temperature through bladder temperature measurement,accurately perform hypothermia treatment for critically ill patients,ensure patient′s comfort,and improve the accuracy and safety of performing cooling blanket operations by nurse

关 键 词：降温毯 测温尿管 膀胱温 直肠温 医院感染控制 风险管理 

分 类 号：R472.5[医药卫生—护理学] R454.5[医药卫生—临床医学]