预防性加温输液在急诊严重创伤患者中的应用  

Application of prophylactic heating infusion in emergency patients with severe trauma

作　　者：陈浩[1] 胡佳颖 管佳慧[1] CHEN Hao;HU Jiaying;GUAN Jiahui(Department of Emergency,Shanghai Sixth People’s Hospital,Shanghai 200233,China)

机构地区：[1]上海市第六人民医院急诊医学科,上海200233

出　　处：《中国医药导报》2024年第4期192-195,200,共5页China Medical Herald

基　　金：上海市第六人民医院院级科学研究基金项目(X院内-2510)。

摘　　要：目的 探讨预防性加温输液在急诊严重创伤患者中的应用效果。方法 选取2022年1月至12月上海市第六人民医院收治的急诊严重创伤患者84例,采用随机数字表法分为对照组(42例)和观察组(42例)。对照组采用常规干预和常规保温措施,观察组在对照组的基础上进行预防性加温输液。比较两组体温值、凝血指标和酸碱指标变化,28 d存活率,寒战、低体温发生率。结果 两组体温组间、时间点及交互作用比较,差异有统计学意义(P<0.05)。进一步两两比较,组内比较:两组组内各时间点体温值比较,差异无统计学意义(P>0.05);组间比较:观察组入院后4、8、12、24 h体温值高于对照组,差异有统计学意义(P<0.05)。两组TT水平组间、时间点及交互作用比较,差异有统计学意义(P<0.05)。其中,两组入院后24 h TT水平高于入院时,观察组入院6、12、24 h TT水平低于对照组,差异有统计学意义(P<0.05)。两组不同时间FIB水平比较,差异有统计学意义(P<0.05)。其中两组入院后24 h FIB水平低于入院时,差异有统计学意义(P<0.05)。两组不同时间点血乳酸水平比较,差异有统计学意义(P<0.05)。其中两组入院后6、12、24 h血乳酸水平高于入院时,差异有统计学意义(P<0.05)。两组p H值水平组间、时间点比较,差异有统计学意义(P<0.05)。其中两组入院后6、12、24 h p H值水平低于入院时,差异有统计学意义(P<0.05)。观察组寒战、低体温发生率低于对照组,差异有统计学意义(P<0.05)。两组28 d存活率比较,差异无统计学意义(P>0.05)。结论 预防性加温输液可减少寒战和低体温的发生,并改善患者凝血功能。Objective To explore the application effect of preventive heating infusion in emergency patients with severe trauma.Methods A total of 84 patients with severe trauma in Department of Emergency Shanghai Sixth People's Hospital from January to December 2022 were selected and divided into control group(42 cases) and observation group(42 cases) by random number table method.The control group received routine intervention and routine insulation measures,and the observation group received preventive heating infusion on the basis of the control group.The changes of body temperature,coagulation index,and p H index,28-day survival rate,incidence of chills,and hypothermia were compared between the two groups.Results There were statistically significant differences in body temperature among groups,time points and interactions(P<0.05).Further pairwise comparison and intra-group comparison:there was no significant difference in body temperature between the two groups at each time point(P>0.05).Comparison between groups:the temperature of observation group at 4,8,12,and 24 h after admission was higher than that of control group,and the differences were statistically significant(P<0.05).There were significant differences in TT level among groups time points and interaction(P<0.05).Among them,the TT level at 24 h after admission was higher in the two groups,and the TT levels at 6,12 h,and 24 in the observation group were lower than those in the control group,with statistical significances(P<0.05).The FIB level of the two groups at different time points was compared,and the differences were statistically significant(P<0.05).The FIB level of two groups24 h after admission was lower than that at admission,and the differences were statisti-cally significant(P<0.05).There was statistical significance in blood lactic acid level between the two groups at different time points(P<0.05).The levels of blood lactic acid at 6,12 h,and 24 h after admission were higher than that at admission,and the differences were statistically significant(P

关 键 词：预防性 加温输液 严重创伤 复温效果 凝血功能 酸碱指标 

分 类 号：R64[医药卫生—外科学]