鼓膜测温应用于寒冷环境伤病员体温评估可行性研究

Feasibility study on application of tympanometry in the assessment of body temperature of patients in cold environment

目的评价鼓膜测温方法在寒冷环境下测量伤病员体温的可行性和准确性,探索寒区作战伤病员战现场急救时可行的体温监测方式。方法在-16℃野外环境(风力3级,湿度29%)分别对8头实验猪的鼓膜、食道中下段、直肠温度进行连续监测,通过Bland-Altman方法评价各种体温测量方式所得测量结果的一致性。结果鼓膜测量温度与食道、直肠所测温度相比,均有4.17%的点在95%一致性界限之外,与两者差值的绝对值最大分别为0.110℃和0.290℃,与两者差值平均值分别为0.002℃和0.130℃。结论鼓膜测温方式的测量结果与食道中下段和直肠所反映的核心体温测量结果存在一定偏差,但相对误差较小,可在寒冷条件下的战现场急救和紧急救治阶段评估体温时作为参考。

Objective To evaluate the feasibility and accuracy of tympanic membrane thermometry in the cold environment to measure the body temperature of wounded and sick personnel.Methods In the field environment of-16℃(wind force level 3,humidity 29%),the temperature of eardrum,middle and lower esophagus and rectal of 8 experimental pigs were continuously monitored,and the consistency of the results obtained by various temperature measurement methods was evaluated by Bland-Altman method.Results Compared with the measured temperature of esophagus and rectum,4.17%points were outside the consistent boundary of 95%,with the maximum absolute value of 0.110℃and 0.290℃and the average value of 0.002℃and 0.130℃,respectively.Conclusion There is a certain deviation between the results of tympanic membrane temperature measurement and the results of core body temperature measurement reflected by the middle and lower esophagus and rectum,but the relative erroris small,which can be used as a reference when evaluating body temperature in cold conditions in first aid and emergency treatment.