综合复温法纠正低体温重度创伤患者的临床研究

Effects of comprehensive rewarming in treatment of severe trauma patients with hypothermia

目的研究综合性低体温干预方法在治疗重度创伤低体温患者中的效果。方法87例急诊创伤患者随机分为对照组（43例，采用常规保暖措施及抢救治疗）和实验组（44例，除常规保暖外联合综合性低体温干预方法）。来诊后5min、10min、15min、20min、25min、30min观察两组患者体温变化，30min时检测凝血酶原时间（PT）、部分凝血活酶时间（Anrr）、凝血酶时间（TT）、纤维蛋白原（FIB）。统计抢救成功率。结果实验组患者体温在各观察时点均显著高于对照组（均P〈0．05）。30min时实验组的PT、APTT、TT和FIB较对照组更接近正常（均P〈0．05）。实验组抢救成功率96．54％，显著高于对照组（89．29％，P〈0．05）。结论综合性低体温干预方法可及时纠正创伤患者低体温状态，改善凝血功能，减少低体温的不良影响，提高抢救成功率。

Objective To investigate the effects of comprehensive rewarming in treating severe trauma patients. Methods Eighty-seven severe trauma patients were randomly divided into 2 groups： control group （n=43, undergoing conventional body tremperature preservation and rescue treatment）, and experimental group （n=44, undergoing infusuion of hot fluid/blood at the temperature of 36℃ and inhalation of 40 -45℃ hot and humid oxyugen during ventilation in addition to the routine treatment）. The body temperature was monitored with electronic sensing probe through urethral catheter and the values 5, 10,15, 20, and 30 min after arrival to the emergency room were recorded. The blood coagulation indexes： prothrombin time （PT）, active partial thromboplastin time （AFFF）, thrombin time （TT）, and fibrinogen （FIB） were detected 30 min after arrival. The rescue success rates were compared. Results The values of body temperature of the experimental group patients at any time-point were all significantly higher than those of the control group （all P 〈 0.05）. The values of PT, AFTT, TT, and FIB of the experimental group were all nearer to the normal values compared with the control group （all P 〈 0.05）. The rescue success rate of the experimental group was 96.54%, significantly higher than thsive hypotherraia intervention methods effectively correct the low temperature condition of trauma patients in time, improve the function of blood coagulation, reduce the bad influence of hypothermia, and improve the rescue success rate.at of the control group （89.29%, P〈 0.05）. Conclusion The comprehensive hypothermia intervention methods effectively correct the low temperature condition of trauma patients in time, improve the function of blood coagulation, reduce the bad influence of hypothermia, and improve the rescue success rate.