目的：探讨低体温对严重创伤患者凝血功能及预后的影响，为创伤患者的治疗提供参考。方法：选择严重创伤患者68例，根据入院第1个24 h内的体温分为正常体温组（36～38℃）和低体温组（＜36℃），比较两组的凝血功能指标及预后情况。结果：低体温组APTT、PT、TT较正常体温组明显延长，Fib、PLT明显减少，D-D明显增加，差异有统计学意义（ P＜0．05）。低体温组ISS评分、感染率、DIC及死亡率明显高于正常体温组，差异有统计学意义（P＜0．05）。结论：严重创伤患者易发生低体温，低体温对机体凝血功能及预后均可产生不良影响。因此，积极监测体温变化并采取有效保温措施，对降低患者死亡率、改善预后有着重要意义。

Objective:To investigate the effect on coagulation function and prognosis of patient with severe trauma because of low temperature , and to provide reference for treatment of trauma patients .Methods:Sixty-eight cases of patients with severe trauma were divided into normal temperature group ( 36-38℃) and low temperature group (<36℃) according to the temperature in the first 24 h at being hospitalized .The coagulation indexes and prognosis were compared between two groups .Results: APTT, PT, TT in low temperature group were longer obviously than those in normal temperature group .the Fib, PLT decreased significantly , the D-D increased significantly , the differences were statistically significant (P<0.05).The ISS score, infection rate, DIC incidence and mortality in low temperature group were significantly higher than those in normal group , the differences were statistically significant ( P<0.05).Conclusion:Patients with severe trauma are prone to low temperature ,low temp

目的探讨持续质量改进（CQI）在手术室防止患者术中低体温的应用效果。方法选择2013年3月至2014年3月期间在我院接受手术治疗的患者112例,根据其接受护理的方式分为CQI组和常规组两组,CQI组应用持续质量改进方法,术前进行低体温危险因素评估,制定相应的护理流程,术中对易发生低体温的患者实施针对性的预防措施,术后对患者出现术中低体温的现状、原因进行分析,并对改进结果进行系统客观评价。常规组采用常规护理方法,比较两组患者术中低体温的发生率。结果经分析可知患者自身因素、年龄因素、术中应用麻醉药物、手术室温度过低、输液输血等原因均可造成手术室患者术中低体温;术毕时两组患者体温均较术前有所下降,且CQI组与术前相比差异有统计学意义（P〈0.05）;CQI组在手术进行15、30、60 min及术毕时体温均较常规组高,差异有统计学意义（P〈0.05）。CQI组有6例术中出现低体温,低体温发生率为10.72%,常规组出现19例,低体温发生率为33.93%,两组低体温发生率差异有统计学意义（P〈0.05）。结论应用持续质量改进方法可以有效预防手术室内患者术中发生低体温情况。

Objective To investigate the continuous quality improvement (CQI) technique in the application effect of low temperature to prevent patients in the operating room.Methods in March, 2013 - March 2013 in our hospital during the surgery treatment of 112 cases of patients, according to the accept care into the CQI group and routine group two groups, the CQI group by the method of continuous quality improvement, preoperative risk factors for low temperature evaluation, formulate corresponding nursing process, patients with intraoperative hypothermia for easy happened corresponding prevention measures, the present situation of low temperature, and the problems of patients after reason is analyzed, and the improved results are objective evaluation system. The conventional nursing methods conventional group, compared two groups of patients in the incidence of low body temperature.Results Through the analysis on the patient''s own factors, age, intraoperative application of narcotic d

低体温是外科手术中常见的并发症之一.随着医学模式的转变,以人为本的服务是现代手术室护理发展的方向和趋势,手术室护士应掌握低体温及其危害因素、并发症、预防和治疗措施知识,有效评估治疗和预防低体温.本文针对近年来术中发生低体温的原因和相应护理措施进行综述,现报道如下.

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了解急诊科护士对创伤患者低体温相关知识水平、对待创伤患者围术期体温监测和管理的态度,以期为以后的研究提供依据。方法:采用自行设计的调查问卷对我市3家三级甲等医院急诊科183名护士进行问卷调查。结果:63.39%的急诊科护士明确低体温的定义,91.26%的急诊科护士认为最接近体核温度的部位是直肠,急诊科护士能列出16种导致低体温的原因,10条复温注意事项。结论:急诊科护士对创伤患者低体温相关知识的掌握不够全面和深入,对体温监测和管理水平有待提高。

To ascertain the emergency nurse understanding on issues associated with hypothermia and attitude regarding the monitoring and man-agement in trauma patients,and gain opportunities for ongoing and further research were identified. Methods:Data collection instrument by self-design was distributed to nursing staff (n=183) employed to work in the emergency department of top three hospitals of Naijing. Results:63. 39% of emergency nurses were unsured how to define hypothermia. 91. 26% respondents chose rectum as the location nearest Tc. There were 16 factors that can lead to hypothermia. 10 items should be noticed with rewarming. Conclusion:Issues that emergency nurses lack of knowledge about hypothermia. An algorithm to guide staff on ways to improve the monitoring and management of temperature in trauma patients was developed.

探讨综合保温护理对老年患者术中低体温及术后并发症的影响。方法:选取我院2009年11月~2012年11月老年行择期全麻手术患者170例,随机分为对照组和实验组各85例,对照组常规护理,实验组进行综合保温护理,比较两组患者术中低体温的发生情况,术后气管导管拔管时间和清醒时间以及术后寒战和躁动情况。结果:实验组患者发生低体温25例,低体温发生率为29.4%;对照组发生低体温66例,低体温发生率为77.6%,实验组术中低体温发生率明显低于对照组(P0.01);实验组在气管拔管时间和清醒时间均较对照组明显缩短(P0.05);实验组术后寒战、躁动等术后并发症发生情况均明显低于对照组(P0.05)。结论:对老年全麻手术患者进行综合保温护理,不仅降低术中低体温的发生,同时缩短了术后麻醉清醒时间和拔管时间,大大降低寒战、躁动等不良反应的发生率,值得临床医院推广应用。

Objective :To investigate the effect of comprehensive insulation care on intraoperative hypothermia and postoperative complications in elderly surgical patients .Methods :170 elderly patients who received operation under general anesthesia in our hos-pital from November 2009 to November 2012 were randomly divided into the control group and the experimental group (85 cases in each group) .The routine nursing care was taken in the control group and the comprehensive insulation care was implemented in the experimental group .The incidence of intraoperative hypothermia ,postoperative extubation time ,recovery time and the occurrence of postoperative shivering and restless of the patients were compared between the two groups .Results :The intraoperative hypo-thermia occurred in 25 patients and the incidence was 29 .4% in the experimental group ;it occurred in 66 patients and the incidence was 77 .6% in the control group (P<0 .01);the postoperative extubation time and recovery time