儿童红外耳温计鼓膜测温与水银体温计肛门测温的比较研究

Comparison between tympanic temperature measurement with infrared ear thermometer and rectal ;temperature measurement with mercury clinical thermometer for children

目的：探讨红外耳温计应用于儿童体温测量的可行性。方法测量500例门、急诊患儿的耳温和肛温，采用自身对照的方法比较耳温和肛温之间的差异,根据年龄不同分为0～1岁组，＞1～2岁组，＞2～3岁组，＞3～7岁组,比较不同年龄组之间2种测量方法差值的差异。结果肛温总均值为（38.28±0.93）℃，耳温总均值为（38.06±0.92）℃，肛温高于耳温，差异有统计学意义（t=-12.711，P=0.000）；0～1岁组，＞1～2岁组，＞2～3岁组，＞3～7岁组4个年龄组肛温减耳温差值的中位数M（Q25，Q75）分别为：0.2（0.0，0.5），0.2（0.1，0.4），0.2（0.0，0.4），0.2（0.0，0.4），不同年龄组2种测量方法差值比较差异无统计学意义（H=0.600，P=0.896）；耳温与肛温呈直线相关（r=0.915，P=0.000）；以肛温为Y，耳温为X的回归方程为=3.080＋0.925X；以肛温≥38.0℃作为金标准，耳温结果ROC曲线下的面积为0.97，耳温诊断发热正确度为高度正确，耳温判断儿童发热的标准建议定为≥37.8℃；肛温与耳温对500例儿童体温判断的发热率分别为58.2%与57.2%，2种测温方法判断发热率差异无统计学意义（χ2=0.102，P=0.749）。结论红外耳温计可以代替水银肛温计应用于儿童体温测量，但临床判断发热的标准耳温与肛温应有区别。

Objective To explore the feasibility for application of infrared ear thermometer in body temperature measurement among children. Method Ear temperature and rectal temperature of 500 children patients at outpatient and emergency departments were measured and the difference between ear temperature and rectal temperature were compared with the self-control method. With 500 children patients were divided into the following groups：0-1 year old group,〉1-2 years old group,〉2-3 years old group, 〉 3- 7 years old group, the difference of these two measuring methods in these different age groups were compared. Results Average rectal temperature was （38.28 ± 0.93）℃, higher than average ear temperature （38.06 ± 0.92） ℃ with statically significant difference （t =-12.711, P =0.000）; 0-1 year old group,〉1-2 years old group,〉2-3 years old group,〉3-7 years old group, four age groups rectal temperature minus ear temperature difference results M（Q25, Q75） were as follows： 0.2（0.0, 0.5）, 0.2 （0.1, 0.4） 0.2 （0.0,0.4） 0.2（0.0,0.4）, which meant the difference between two temperature measurement methods in different age groups showed that the difference was not statistically significant （H=0.600, P=0.896）;ear temperature and rectal temperature were linearly correlated （r=0.915, P=0.000）;taking rectal temperature as Y and ear temperature as X, the regression equation was =3.080＋0.925X;with rectal temperature of≥38.0℃as golden standard, the area in ROC curve of ear temperature was 0.97 and correct diagnosis index of ear temperature was highly correct. Therefore, as for whether a child is diagnosed as fever based on the ear temperature, it is recommended that the ear temperature be≥37.8℃;the difference of fever incidencefor rectal temperature method of 58.2%and fever incident for ear temperature method of 57.2%was determined as not statistically significant （χ2=0.102,P=0.749）. Conclusions Infrared ear thermometer may be used for measuring children′s body temperature by replacing mercury rectal thermometer; however, ear temperature should be different from rectal temperature in terms of criteria for clinical judgment of fever.