综合复温管理措施对低体温严重创伤患者的影响研究

The impact of comprehensive rewarming management measures on patients with severe trauma and hypothermia

目的探讨综合复温管理措施对在低体温严重创伤患者的生理参数和血气指标的影响。方法选取2014年1~12月在急诊就医时发生低体温的72例严重创伤患者作为对照组并实施常规的体温护理,选取2015年1~12月的76例患者作为观察组并实施综合体温管理。比较2组患者入院24h的生理参数和血气指标。结果 2组患者在入院时和入院2、4、6、8、10、12h的生理指标变化的组间效应、时间效应以及交互效应差异均具有显著意义(P<0.001);在入院时、入院6h和入院12h的pH值变化的组间效应、时间效应以及交互效应均具有统计学意义(P<0.05),而乳酸和凝血酶原时间仅时间效应差异具有统计学意义(P<0.001)。结论综合体温管理措施能有效促进严重创伤低体温患者复温,提高生理和血气指标的稳定性,对改善低体温严重创伤患者的救治效果具有重要的临床意义。

Objective To explore the impact of comprehensive rewarming management measures on the physiological parameters,and blood gas indexes of patients with severe trauma and hypothermia.Methods Seventy-two patients with severe trauma and hypothermia admitted between January and December 2014 were selected into the control group and given routine nursing care,another 76 counterparts admitted between January and December 2015 were chosen into the observation group and provided with comprehensive temperature management.The physiological parameters and blood gas indexes in 24 hours after admission were collected and compared between the two groups.Results Significant differences were observed in the physiological indexes at 0,2,4,6,8,10,12 hours after the admission between the two groups（P〈0.001）.The intergroup effect,time effect and interaction effect of pH value variance had significant differences at 0hour,6hours and 12 hours after the admission（P〈0.05）.There were significant differences in the lactic acid and prothrombin among different times（P〈0.001）.Conclusion Comprehensive temperature management scheme can effectively help patients with severe trauma and hypothermia rewarm and improve the stability of their physiological and blood gas index,which has important clinical significance for facilitating the treatment effect of patients with severe trauma and hypothermia.