中华急危重症护理杂志 ›› 2025, Vol. 6 ›› Issue (9): 1082-1088.doi: 10.3761/j.issn.2096-7446.2025.09.009
收稿日期:
2025-02-04
出版日期:
2025-09-10
发布日期:
2025-09-02
作者简介:
金丁萍:女,本科,副主任护师,E-mail:2196012@zju.edu.cn
JIN Dingping(), WANG Sa, WANG Yuwei, FENG Xiuqin, XU Shurong, YAN Danping
Received:
2025-02-04
Online:
2025-09-10
Published:
2025-09-02
摘要:
目的 对创伤患者低体温影响因素、监测工具、监测频率与体温管理策略进行范围综述,为优化创伤患者体温管理提供参考。 方法 以澳大利亚乔安娜布里格斯研究所2020版范围综述方法为框架,系统检索PubMed、Web of Science、Embase、Cochrane Library、CINAHL、中国知网、万方数据库及维普数据库,检索时限为2016年1月1日—2024年12月27日。对创伤患者低体温影响因素、体温监测工具、监测频率与体温管理方案进行归纳。 结果 共纳入16篇文献,创伤患者低体温影响因素包括创伤程度、潮湿衣物覆盖、室外温度以及患者体位,耳温测量是提及最多的监测方式,测量频率波动在持续测量至每2 h测量,复温方式分为体外、体内复温。 结论 创伤患者体温的监测工具、监测频率与管理方案繁多,未来的研究应在多中心、大样本背景下明确不同创伤机制患者的体温最佳监测工具、频率与管理方案。
金丁萍, 王飒, 王钰炜, 封秀琴, 许书荣, 闫丹萍. 创伤患者低体温影响因素及管理策略的范围综述[J]. 中华急危重症护理杂志, 2025, 6(9): 1082-1088.
JIN Dingping, WANG Sa, WANG Yuwei, FENG Xiuqin, XU Shurong, YAN Danping. Factors influencing hypothermia in trauma patients and management strategies:a scoping review[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1082-1088.
[1] | Haagsma JA, Graetz N, Bolliger I, et al. The global burden of in-jury:incidence,mortality,disability-adjusted life years and time trends from the global burden of disease study 2013[J]. Inj Prev, 2016, 22(1):3-18. |
[2] | Duan LL, Ye PP, Haagsma JA, et al. The burden of injury in China,1990-2017:findings from the global burden of disease study 2017[J]. Lancet Public Health, 2019, 4(9):e449-e461. |
[3] | 涂加园. 创伤后患者低体温风险评估量表的研制[D]. 南京: 南京大学, 2019. |
Tu JY. Development of hypothermia risk assessment scale for post-traumatic patients[D]. Nanjing: Nanjing University, 2019. | |
[4] | Rösli D, Schnüriger B, Candinas D, et al. The impact of accidental hypothermia on mortality in trauma patients overall and patients with traumatic brain injury specifically:a systematic review and meta-analysis[J]. World J Surg, 2020, 44(12):4106-4117. |
[5] | Perlman R, Callum J, Laflamme C, et al. A recommended early goal-directed management guideline for the prevention of hypothermia-related transfusion,morbidity,and mortality in severely injured trauma patients[J]. Crit Care, 2016, 20(1):107. |
[6] | 杨旻斐, 王钰炜, 詹玥, 等. 基于指南的加温输液输血策略对严重创伤伴低体温患者复温效果的研究[J]. 中华急诊医学杂志, 2018, 27(5):492-498. |
Yang MF, Wang YW, Zhan Y, et al. Effects of heating intravenous fluid infusion and blood transfusion based on guidelines in sever trauma patients with hypothermia[J]. Chin J Emerg Med, 2018, 27(5):492-498. | |
[7] | 顾丹婷, 赵燕. 分级复温护理对急诊创伤患者低体温及并发症的影响[J]. 当代护士(中旬刊), 2023, 30(7):108-111. |
Gu DT, Zhao Y. The influence of graded rewarming nursing on hypothermia and complications in emergency trauma patients[J]. Mod Nurse, 2023, 30(7):108-111. | |
[8] | 颜雷雷, 廖德珺, 金倩倩, 等. 系统分级复温措施对急诊创伤手术患者体温及预后的影响[J]. 中华危重病急救医学, 2021, 33(12):1459-1465. |
Yan LL, Liao DJ, Jin QQ, et al. Effect of systematic graded rewarming measures on body temperature and prognosis of patients undergoing emergency trauma surgery[J]. Chin Crit Care Med, 2021, 33(12):1459-1465. | |
[9] | Peters MDJ, Godfrey C, McInerney P, et al. Scoping Reviews(2020)[EB/OL]. [2024-03-27]. https://jbi-global-wiki.refined.site/space/MANUAL/355862497/10. |
[10] | 王旭, 魏武运. 体温管理联合限制性液体复苏对多发伤伴失血性休克患者低体温及应激反应的影响[J]. 临床医学研究与实践, 2024, 9(26):66-69. |
Wang X, Wei WY. Effects of temperature management combined with limited fluid resuscitation on hypothermia and stress response in patients with multiple injury and hemorrhagic shock[J]. Clin Res Pract, 2024, 9(26):66-69. | |
[11] |
吕洋洋, 卢阳阳, 黄海群, 等. 系统分级复温模式对低体温创伤患者不同时段全因死亡的影响[J]. 中国医学科学院学报, 2023, 45(2):213-220.
doi: 10.3881/j.issn.1000-503X.15113 |
Lü YY, Lu YY, Huang HQ, et al. Effect of systematic graded rewarming pattern on all-cause mortality of hypothermic trauma patients in different time periods[J]. Acta Acad Med Sin, 2023, 45(2):213-220.
doi: 10.3881/j.issn.1000-503X.15113 |
|
[12] | 马蓉, 邵长华, 刘洁. 急诊创伤后患者低体温管理方案的构建及应用效果[J]. 国际护理学杂志, 2023, 42(12):2257-2261. |
Ma R, Shao CH, Liu J. Construction and application effect of the hypothermia management program for patients after trauma in the emergency department[J]. Inter J Nurs, 2023, 42(12):2257-2261. | |
[13] | 赵江宁, 苏晓丽, 密弘飞, 等. 集束化保温措施联合一站式急救护理模式在创伤后自发性低体温患者中的应用效果[J]. 临床医学研究与实践, 2023, 8(30):118-121. |
Zhao JN, Su XL, Mi HF, et al. Application effect of cluster heat preservation measures combined with one-stop emergency nursing mode in patients with spontaneous hypothermia after trauma[J]. Clin Res Pract, 2023, 8(30):118-121. | |
[14] | 张叶华. 流程化体温管理在急诊创伤患者中的应用效果[J]. 当代护士(上旬刊), 2021, 28(5):136-138. |
Zhang YH. The application effect of process-oriented body temperature management in emergency trauma patients[J]. Mod Nurse, 2021, 28(5):136-138. | |
[15] | 周守志, 尹弘青, 汪强, 等. 前馈控制在急诊严重创伤患者体温管理中应用的实效研究[J]. 护理管理杂志, 2022, 22(11):773-776,787. |
Zhou SZ, Yin HQ, Wang Q, et al. The application and effect of feedforward control program in management of temperature for trauma patients in emergency[J]. J Nurs Adm, 2022, 22(11):773-776,787. | |
[16] | 王瑞. 循证干预在急诊创伤低温中的应用及对体温恢复的影响研究[J]. 中文科技期刊数据库(全文版)医药卫生, 2022(8):57-60. |
Wang R. Research on the application of evidence-based intervention in emergency traumatic hypothermia and its impact on body temperature recovery[J]. Chin Sci Tech J Database(Full-text Version)-Medi Health, 2022(8):57-60. | |
[17] | 林玉琴, 顾莉萍, 张宁, 等. 一站式密集型急诊管理在创伤急诊抢救室中的应用[J]. 护理实践与研究, 2019, 16(24):136-138. |
Lin YQ, Gu LP, Zhang N, et al. Application of one-stop intensive emergency management in trauma emergency room[J]. Nurs Pract Res, 2019, 16(24):136-138. | |
[18] |
徐二喜, 顾丽嫦, 李家婵, 等. 综合复温管理措施对低体温严重创伤患者的影响研究[J]. 中国临床护理, 2017, 9(4):340-344.
doi: 10.3969/j.issn.1674-3768.2017.04.020 |
Xu EX, Gu LC, Li JC, et al. The impact of comprehensive rewarming management measures on patients with severe trauma and hypothermia[J]. Chin Clin Nurs, 2017, 9(4):340-344.
doi: 10.3969/j.issn.1674-3768.2017.04.020 |
|
[19] | Weuster M, Brück A, Lippross S, et al. Epidemiology of accidental hypothermia in polytrauma patients:an analysis of 15,230 patients of the Trauma Register DGU[J]. J Trauma Acute Care Surg, 2016, 81(5):905-912. |
[20] |
McLellan H, Rijnhout TWH, Michael Peterson L, et al. Prehospital active and passive warming in trauma patients[J]. Air Med J, 2023, 42(4):252-258.
doi: 10.1016/j.amj.2023.03.005 pmid: 37356885 |
[21] | Mota MAL, Santos MR, Santos EJF, et al. Trauma prehospital hypothermia prevention and treatment:an observational study[J]. J Trauma Nurs, 2021, 28(3):194-202. |
[22] | 李雯, 蒋娟, 段晶晶, 等. 急诊创伤后发生自发性低体温的影响因素及其相关性[J]. 国际护理学杂志, 2020, 39(4):599-602. |
Li W, Jiang J, Duan JJ, et al. Influencing factors and their correlations of spontaneous hypothermia after emergency trauma[J]. Int J Nurs, 2020, 39(4):599-602. | |
[23] | 刘力行, 聂时南, 刘云, 等. 急诊创伤后自发性低体温发生情况及其影响因素的调查研究[J]. 中华护理杂志, 2017, 52(2):182-186. |
Liu LX, Nie SN, Liu Y, et al. Incidence and its influencing factors of spontaneous hypothermia in trauma patients in emergency:a multicenter investigation[J]. Chin J Nurs, 2017, 52(2):182-186. | |
[24] | Lapostolle F, Couvreur J, Koch FX, et al. Hypothermia in trauma victims at first arrival of ambulance personnel:an observational study with assessment of risk factors[J]. Scand J Trau-ma Resusc Emerg Med, 2017, 25(1):43. |
[25] | Peng RY, Bongard FS. Hypothermia in trauma patients[J]. J Am Coll Surg, 1999, 188(6):685-696. |
[26] |
Choudhary RC, Jia XF. Hypothalamic or extrahypothalamic modulation and targeted temperature management after brain injury[J]. Ther Hypothermia Temp Manag, 2017, 7(3):125-133.
doi: 10.1089/ther.2017.0003 pmid: 28467285 |
[27] | 景晨阳, 郭越, 樊落, 等. 急诊创伤患者低体温影响因素的Meta分析[J]. 中华急危重症护理杂志, 2024, 5(2):131-137. |
Jing CY, Guo Y, Fan L, et al. Risk factors of hypothermia in emergency trauma patients:a meta-analysis[J]. Chin J Emerg Crit Care Nurs, 2024, 5(2):131-137. | |
[28] | 李博, 徐海莉, 闫文润, 等. 急性创伤患者低体温发生率及其影响因素分析[J]. 中华现代护理杂志, 2018, 24(18):2179-2181. |
Li B, Xu HL, Yan WR, et al. Analysis of incidence of hypothermia and its influencing factors in patients with acute trauma[J]. Chin J Mod Nurs, 2018, 24(18):2179-2181. | |
[29] | 邓妍, 黄珍玲, 张莉莉, 等. Glasgow评分在急性创伤患者低体温发生中的预测作用[J]. 临床与病理杂志, 2019, 39(12):2787-2791. |
Deng Y, Huang ZL, Zhang LL, et al. Predictive effect of Glas-gow Coma Scale on hypothermia in patients with acute trauma[J]. J Clin Pathol Res, 2019, 39(12):2787-2791. | |
[30] |
Forristal C, Van Aarsen K, Columbus M, et al. Predictors of hypothermia upon trauma center arrival in severe trauma patients transported to hospital via EMS[J]. Prehosp Emerg Care, 2020, 24(1):15-22.
doi: 10.1080/10903127.2019.1599474 pmid: 30945956 |
[31] | 张文英, 皇芳芳, 徐洪云. 基于Logistic回归分析构建急诊创伤后患者自发性低体温预测模型[J]. 国际护理学杂志, 2023, 42(1):165-168. |
Zhang WF, Huang FF, Xu HY. A prediction model for spontaneous hypothermia in emergency patients after trauma was constructed based on Logistic regression analysis[J]. Inter J Nurs, 2023, 42(1):165-168. | |
[32] | Robinson JL, Seal RF, Spady DW, et al. Comparison of esophageal,rectal,axillary,bladder,tympanic,and pulmonary artery temperatures in children[J]. J Pediatr, 1998, 133(4):553-556. |
[33] |
Fritsch DE. Hypothermia in the trauma patient[J]. AACN Clin Issues, 1995, 6(2):196-211.
pmid: 7743424 |
[34] |
Hart D, Rischall M, Durgin K, et al. Non-invasive zero-heat-flux technology compared with traditional core temperature measurements in the emergency department[J]. Am J Emerg Med, 2020, 38(11):2383-2386.
doi: 10.1016/j.ajem.2020.08.071 pmid: 33041152 |
[35] |
Rzechorzek NM, Thrippleton MJ, Chappell FM, et al. A daily temperature rhythm in the human brain predicts survival after brain injury[J]. Brain, 2022, 145(6):2031-2048.
doi: 10.1093/brain/awab466 pmid: 35691613 |
[36] |
Buttram SDW, Au AK, Koch J, et al. Feasibility study evaluating therapeutic hypothermia for refractory status epilepticus in children[J]. Ther Hypothermia Temp Manag, 2015, 5(4):198-202.
doi: 10.1089/ther.2015.0016 pmid: 26562493 |
[37] |
Bhatti F, Naiman M, Tsarev A, et al. Esophageal temperature management in patients suffering from traumatic brain injury[J]. Ther Hypothermia Temp Manag, 2019, 9(4):238-242.
doi: 10.1089/ther.2018.0034 pmid: 30657435 |
[38] |
Bukur M, Hadjibashi AA, Ley EJ, et al. Impact of prehospital hypothermia on transfusion requirements and outcomes[J]. J Trauma Acute Care Surg, 2012, 73(5):1195-1201.
doi: 10.1097/TA.0b013e31826fc7d9 pmid: 23117380 |
[39] | Hewett Brumberg EK, Douma MJ, Alibertis K, et al. 2024 American heart association and American red cross guidelines for first aid[J]. Circulation, 2024, 150(24):e519-e579. |
[40] | 左红霞, 张超, 黄健健, 等. 不同术前禁食禁饮时间对我国择期全身麻醉患者围手术期影响的系统评价[J]. 华西医学, 2018, 33(8):1005-1014. |
Zuo HX, Zhang C, Huang JJ, et al. The perioperative effect of non-peros time on elective general anesthesia patients in China:a systematic review[J]. West China Med J, 2018, 33(8):1005-1014. | |
[41] | 吴金玉, 帅俊坤, 上官非凡, 等. 急诊成人创伤患者自发性低体温院内管理的最佳证据总结[J]. 中华急危重症护理杂志, 2022, 3(6):513-519. |
Wu JY, Shuai JK, Shangguan FF, et al. Summary of best evidence for in-hospital management of spontaneous hypothermia in emergency adult trauma patients[J]. Chin J Emerg Crit Care Nurs, 2022, 3(6):513-519. |
[1] | 王雪琴, 吕颖, 赵庆华, 张川林, 米洁. 早期活动多学科协作模式在机械通气患者中的实施效果研究[J]. 中华急危重症护理杂志, 2025, 6(9): 1029-1035. |
[2] | 彭莉, 徐翠荣, 冯波, 姚媛媛, 邢星敏, 俞琳. 预防ICU连续肾脏替代治疗患者非计划下机管理方案的构建及适用性分析[J]. 中华急危重症护理杂志, 2025, 6(9): 1036-1041. |
[3] | 叶洪敏, 甘秀妮, 高燕, 张欢, 周雯, 李冬雪. 脑出血患者静脉血栓栓塞症风险预测模型的构建及验证研究[J]. 中华急危重症护理杂志, 2025, 6(9): 1042-1049. |
[4] | 李继红, 王爽. 护理临床研究伦理审查的挑战及对策[J]. 中华急危重症护理杂志, 2025, 6(9): 1050-1054. |
[5] | 潘银芝, 姚晓月, 杨旻斐, 陈芳, 陈彬, 郑成, 张勇. 急性开放性创面数字化管理方案的构建及效果评价[J]. 中华急危重症护理杂志, 2025, 6(9): 1055-1060. |
[6] | 王伶俐, 刘小琴, 陈天喜, 赵旭东, 冒飒娴, 薛施霞, 姜慧. 急诊严重创伤患者救治时效质量评价指标的构建及应用研究[J]. 中华急危重症护理杂志, 2025, 6(9): 1061-1066. |
[7] | 杨云利, 张晓峰, 刘亚楠, 王华荣. 急诊老年创伤患者分诊标准研究的范围综述[J]. 中华急危重症护理杂志, 2025, 6(9): 1074-1081. |
[8] | 赵佳义, 王淑君, 祝红娟. 批量危重烧伤患者院内二次检伤分诊管理的研究进展[J]. 中华急危重症护理杂志, 2025, 6(9): 1089-1093. |
[9] | 肖倩云, 黄晓霞, 周鑫滢, 叶欢, 周丽萍. 极重度肥胖伴肺栓塞患者的多学科协作护理[J]. 中华急危重症护理杂志, 2025, 6(9): 1094-1096. |
[10] | 孙淼娟, 何佩佩, 项世龙, 胡丽君. 腹膜透析患者胸腹瘘的早期识别及围手术期护理[J]. 中华急危重症护理杂志, 2025, 6(9): 1097-1099. |
[11] | 郭京, 靳瑾, 王欣然. 高甘油三酯血症性急性胰腺炎患者行连续性肾脏替代治疗联合血液吸附的护理[J]. 中华急危重症护理杂志, 2025, 6(9): 1100-1102. |
[12] | 袁翠, 肖艳艳, 陈凯笙, 王芳, 王轶, 胡美华, 姚希, 王东信, 李双玲. 预防性接触隔离集束化措施对ICU多重耐药菌感染防控效果的研究[J]. 中华急危重症护理杂志, 2025, 6(9): 1106-1111. |
[13] | 杨小娜, 徐彩娟, 张玉萍, 王丽竹, 李茜, 葛澜, 兰美娟. 护理硕士专业学位研究生整合式危重症教学的设计与实践[J]. 中华急危重症护理杂志, 2025, 6(9): 1118-1123. |
[14] | 宋萍, 胡敏, 曾洁. 化疗诱导的周围神经病变评估及护理的最佳证据总结[J]. 中华急危重症护理杂志, 2025, 6(9): 1124-1130. |
[15] | 邹颖, 陈偶英, 丁俊豪, 刘苹, 李妮吉娜. 危重症护理研究热点的文献计量分析[J]. 中华急危重症护理杂志, 2025, 6(9): 1131-1137. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||