急诊创伤患者低体温影响因素的Meta分析

Risk factors of hypothermia in emergency trauma patients:a meta-analysis

目的通过Meta分析明确急诊创伤患者发生低体温的影响因素。方法计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase、Cochrane Library等数据库中关于急诊创伤患者低体温影响因素的队列研究和病例对照研究,检索时限为建库至2023年7月,由两名研究者独立进行文献筛选、数据提取、质量评价后,采用RevMan 5.4.1软件进行Meta分析。结果共纳入10篇文献,包括8个影响因素:收缩压(OR=0.99)、修正创伤评分(Revised Trauma Score,RTS)(OR=0.60)、创伤严重程度评分(Injury Severe Score,ISS)(OR=1.02)、救护车到达时患者卧于地面(OR=8.22)、气温(OR=0.95)、冬季(OR=2.20)、转运过程中采取保暖措施(OR=0.25)和院前插管(OR=6.41)。结论收缩压、RTS、ISS、救护车到达时患者卧于地面、气温、冬季、转运过程中采取保暖措施和院前插管是急诊创伤患者发生低体温的影响因素。提示护理人员可依据影响因素,针对性地采取预防措施,降低急诊创伤患者低体温发生率,从而减少创伤患者死亡风险。

Objective To clarify the risk factors of hypothermia in emergency trauma patients by meta-analysis.Methods The cohort studies and case-control studies on the risk factors of hypothermia in the trauma patients were searched by computer in CNKI,VIP,WanFang data,CBM,PubMed,Web of Science,Embase,and Cochrane Library.The search time was from the inception of databases until July 2023.After independent literature screening,data extraction,and quality evaluation by two researchers,RevMan 5.4.1 was used for meta-analysis.Results A total of 10 articles were included,including 8 risk factors:systolic blood pressure(OR=0.99),Revised Trauma Score(RTS)(OR=0.60),Injury Severe Score(ISS)(OR=1.02),patients lying on the ground when the ambulance arrived(OR=8.22),temperature(OR=0.95),winter(OR=2.20),warm measures during transport(OR=0.25)and pre-hospital intubation(OR=6.41).Conclusion Systolic blood pressure,RTS,ISS,lying on the ground when the ambulance arrives,air temperature,winter,keeping warm during transport and pre-hospital intubation are the influencing factors of hypothermia in emergency trauma patients.It is suggested that nurses can rely on the influencing factors,take targeted preventive measures to reduce the incidence of hypothermia,thereby reducing the risk of death in trauma patients.