摘要
目的探讨基于指南的加温输液输血策略对严重创伤伴低体温患者的复温效果。方法选取2014年7月至2015年12月于浙江大学医学院附属第二医院就诊的40例严重创伤伴低体温患者作为对照组，给予常规保温措施；2016年1月至2017年7月来本院就诊的40例严重创伤伴低体温患者作为复温组，在常规复温措施的基础上，进行加温输液输血。比较两组患者体核体温、凝血酶原时间和活化部分凝血酶原时间指标、寒颤发生率和病死率的改变情况。结果两组患者0．5h、1．0h、1．5h及3．0h后的体核体温比较，差异有统计学意义（P〈0．05）；3h后的凝血酶原时间和寒颤发生率比较，差异有统计学意义（P〈0．05）；两组患者各个时问点的平均动脉压比较，差异无统计学意义（P〉0．05）。结论加温输液输血对严重创伤伴低体温患者具有显著复温效果，并且可以改善凝血障碍状况和降低寒颤发生率，为探索临床简单方便的复温措施提供借鉴和参考。
Objective To explore the effects of heating intravenous fluid infusion and blood transfusion based on guidelines in severe trauma patients with hypothermia. Methods A total of 40 severe trauma patients with hypotherrnia admitted from July 2014 to December 2015 were enrolled as the control group treated with routine measures to maintain the body temperature at normothermia by such as electrical heating blanket; other 40 severe casualties with hypothermia admitted from January 2016 to July 2017 were recruited as the warming up group treated with heating intravenous fluid infusion and blood transfusion by hot water bath in addition to the routine measures for keeping body temperature at normothermia. The differences in core body temperature, prothrombin time, activated partial thromboplastin time, incidence of shivering and mortality rate were compared between the two groups. Results There was statistically significant difference in core body temperature at 0.5 h, 1.0 h, 1.5 h, 3.0 h between the two groups （P〈0.05）. Though the prothrombin time and shivering were improved after warming up in both groups, and there were significant differences in prothrombin time at 3.0 h after warming up and the incidence of shivering between two groups（P〈0.05）.There was no significant difference in mean arterial pressure at all seven intervals between two groups. Conclusion The heating intravenous fluid infusion and blood transfusion had remarkable effects to prevent hypothermia, improves blood coagulation and reduced the incidence of shivering to provide more simple and convenient warming up intervention for clinical practice.
作者
杨旻斐
王钰炜
詹玥
陈芳
陈鹏远
张欢欢
Yang Minfei;Wang Yuwei;Zhan Yue;Chen Fang;Chen Pengyuan;Zhang Huanhuan(Emergency Department, the Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310051, China)
出处
《中华急诊医学杂志》
CAS
CSCD
北大核心
2018年第5期492-498,共7页
Chinese Journal of Emergency Medicine
基金
浙江省医药卫生科技项目（2016KYB127）
关键词
严重创伤患者
低体温
加温输液输血
复温
Sever trauma patients
Hypothermia
Heating intravenous infusion and blood transfusion
Rewarming
