自制降温毯在小儿心脏术后应用的效果

摘要

目的 观察心脏术后高热患儿使用自制降温毯的临床效果.方法 选择心脏术后高热(肛温≥39.5℃)患儿80例,按照随机数字表法随机分成对照组(n=40)和试验组(n=40).试验组采用自制降温毯进行物理降温,对照组采用传统冰袋在头部、腋下等部位进行物理降温,比较采取降温措施后1,4,8h两组患儿的体温及心率.结果 与降温前比较,试验组患者在1,4,8h后体温分别为(39.03±0.34)、(38.50 ±0.39)、(37.99 ±0.45)℃,对照组分别为(39.50±0.37)、(39.13 ±0.80)、(38.87 ±0.75)℃,两组比较差异有统计学意义(t分别为5.75,4.42,6.33；P均＜0.05).试验组患者在1,4,8h心率均有所降低,与对照组比较在1h时差异无统计学意义,在4,8h时差异有统计学意义(t分别为2.58,3.69；P均＜0.05).试验组患者在降温8h后体温降低幅度大于1h和4h,也大于对照组相应时段.结论 应用自制降温毯降温效果优于采用传统冰袋降温,尤其是远期降温效果明显,有利于心脏术后患儿顺利康复.%Objective To observe the clinical effect of self-made hypothermic blanket on children with high fever after cardiac surgery.Methods Eighty children with high fever after cardiac surgery (anus temperature ≥39.5 ℃ ) were randomly divided into experiment group and control group.The experiment group used self-made hypothermic blanket to cool and the control group used the traditional ice bag on the head,armpits and other parts to cool.To monitor children's body temperature and heart rate after 1 hour,4 hours and 8 hours.Results The temperature at 1 hour,4 hours and 8 hours were (39.03 ±0.34),(38.50 ±0.39) and (37.99 ±0.45)℃ in the experiment group and (39.50±0.37),(39.13 ±0.80),(38.87 ±0.75)℃ in the control group,respectively; and the differences were statistically significant ( t =5.75,4.42,6.33 ;P ＜ 0.05 ).Heart rate reduced at 1 hour,4 hours and 8 hours,but compared with that in the control group,the difference was statistically significant at 4 hours and 8 hours ( t =2.58,3.69 ; P ＜ 0.05 ).The cooling amplitude of the experiment group at 8 hours was obviously higher than that at 1 hour and 4 hours and that in the control group.Conclusions The cooling effect of self-made hypothermic blanket is better than the traditional cooling with ice bag,especially long-term cooling effect and it is cconductive to the rehabilitation of children after cardiac surgery.