体外循环心脏术后危重患者体温信息化管理实践研究

doi:10.3761/j.issn.2096-7446.2025.01.015

摘要/Abstract

摘要：

目的基于信息化管理平台，开发体外循环心脏术后危重患者体温信息化管理平台并探究其临床应用效果。方法成立研究团队，通过文献回顾、小组讨论、专家函询等方法开发体外循环心脏术后危重患者体温信息化管理平台，选取2023年10月—12月在青岛市某三级甲等医院行体外循环心脏手术的患者作为研究对象，进行临床应用并评价应用效果。结果体外循环心脏术后危重患者体温信息化管理平台应用后，患者发热率、低体温率、疼痛评分、气管插管时间较应用前显著降低（均P<0.05）；热舒适度、脑氧饱和度较应用前均有显著提升（均P<0.05）。结论体外循环心脏术后危重患者体温信息化管理平台能够对患者体温实施精准化管理，有利于综合评估与精准干预，有效加强医护协作，促进患者术后康复。

关键词: 体外循环, 心脏手术, 体温, 信息化管理, 危重病护理

Abstract:

Objective To construct a temperature information management program for critically ill patients after extracorporeal circulation heart surgery based on the information management platform，and explore its clinical application effectiveness. Methods The research team was established to construct a temperature information management program for critically ill patients after extracorporeal circulation heart surgery through literature review，group discussion，expert inquiry，and etc.，and develop the body temperature information management platform. Patients who underwent cardiopulmonary bypass cardiac surgery in a tertiary hospital in Qingdao from October to December 2023 were selected as the research subjects to carry out clinical application，and evaluate the application effects. Results After the application of the temperature information management program for critically ill patients after extracorporeal circulation heart surgery，the rate of fever，the rate of hypothermia，pain score，the length of tracheal intubation were significantly reduced compared to those before the application（P<0.05）. The thermal comfort and cerebral oxygen saturation were significantly improved compared to those before the application（P<0.05）. Conclusion The information management program of temperature for critically ill patients after extracorporeal circulation heart surgery could implement precise management of patients’ body temperature，facilitate the comprehensive assessment and precise intervention，effectively strengthen collaboration between doctors and nurses，and promote postoperative recovery of patients.

Key words: Extracorporeal Circulation, Cardiac Surgery, Temperature, Information Management, Critical Care Nursing

刘翠, 魏丽丽, 李琪, 张丛丛, 张艳, 朱福香, 韩晓婕, 宓龙, 崔晓岭. 体外循环心脏术后危重患者体温信息化管理实践研究[J]. 中华急危重症护理杂志, 2025, 6(1): 89-93.

LIU Cui, WEI Lili, LI Qi, ZHANG Congcong, ZHANG Yan, ZHU Fuxiang, HAN Xiaojie, MI Long, CUI Xiaoling. Practical research on temperature information management of critically ill patients after extracorporeal circulation heart surgery[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(1): 89-93.

图/表 2

参考文献 14

[1]	中国生物医学工程学会体外循环分会. 2022年中国心血管外科手术和体外循环数据白皮书[J]. 中国体外循环杂志, 2023, 21(4):197-200.
	Extracorporeal Circulation Branch of Chinese Biomedical Engi-neering Association. White book of Chinese cardiovascular sur-gery and extracorporeal circulation in 2022[J]. Chin J Extra-cor-por Circ, 2023, 21(4):197-200.
[2]	陈孝平, 汪建平, 赵继宗. 外科学[M]. 9版. 北京: 人民卫生出版社,2018:283.
	Chen XP, Wang JP, Zhao JZ. Surgery[M]. 9th ed. Beijing: People’s Medical Publishing House,2018:283.
[3]	安晓燕, 李雪云, 邢星敏, 等. ICU危重患者体温监测的最佳证据总结[J]. 护士进修杂志, 2020, 35(22):2034-2038,2043.
	An XY, Li XY, Xing XM, et al. Summary of the best evidence for temperature monitoring in critical patients admitted to ICU[J]. J Nurses Train, 2020, 35(22):2034-2038,2043.
[4]	Broman ME, Vincent JL, Ronco C, et al. The relationship bet-ween heart rate and body temperature in critically ill patients[J]. Crit Care Med, 2021, 49(3):327-331.
[5]	盖恬恬, 李紫梦, 崔钰, 等. ICU脑损伤患者目标体温管理的最佳证据总结[J]. 中华护理杂志, 2023, 58(21):2653-2661. doi: 10.3761/j.issn.0254-1769.2023.21.014
	Gai TT, Li ZM, Cui Y, et al. Evidence summary for targeted temperature management in brain injury patients with ICU[J]. Chin J Nurs, 2023, 58(21):2653-2661. doi: 10.3761/j.issn.0254-1769.2023.21.014
[6]	张春燕, 何艳, 朱燕梅, 等. 两种核心体温监测法在体外循环术后温度监测中的应用[J]. 国际护理学杂志, 2020, 39(16):2960-2963.
	Zhang CY, He Y, Zhu YM, et al. Application of two core tem-perature monitoring methods in temperature monitoring after extracorporeal circulation[J]. Int J Nurs, 2020, 39(16):2960-2963.
[7]	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.
[8]	季国忠. 病历书写规范[M]. 2版. 南京: 东南大学出版社,2015:105.
	Ji GZ. Writing standards for medical records[M]. 2nd ed. Nan-jing: Southeast University Press,2015:105.
[9]	Perl T, Peichl LH, Reyntjens K, et al. Efficacy of a novel prewarming system in the prevention of perioperative hypo-thermia. A prospective,randomized,multicenter study[J]. Mine-rva Anestesiol, 2014, 80(4):436-443.
[10]	钟芳, 贾宏业. 路径化疼痛管理联合积极心理暗示在机器人导航辅助治疗创伤性骨折患者中的应用[J]. 中华现代护理杂志, 2023, 29(18):2463-2467.
	Zhong F, Jia HY. Effects of path-based pain management combined with positive psychological suggestion on robot navigation-assisted treatment of patients with traumatic frac-tures[J]. Chin J Mod Nurs, 2023, 29(18):2463-2467.
[11]	陈京缦, 秦素萍, 韩小红, 等. 膀胱温度监测在不同术式心脏手术患者中的应用[J]. 中华现代护理杂志, 2015,(11):1264-1266.
	Chen JM, Qin SP, Han XH, et al. Application of bladder tem-perature monitoring in patients undergoing different cardiac surgeries[J]. Chin J Mod Nurs, 2015,(11):1264-1266.
[12]	向薇, 王泽先, 杨茂欣, 等. 基于护理信息系统发热病人体温单的应用现状与改进研究[J]. 全科护理, 2017, 15(5):589-590.
	Xiang W, Wang ZX, Yang MX, et al. Application status and improvement of temperature sheet for patients with fever based on nursing information system[J]. Chin Gen Pract Nurs, 2017, 15(5):589-590.
[13]	王静玉, 符聪, 荀玉月, 等. 不同体温管理策略对老年单肺通气患者脑氧饱和度变化率和术后谵妄的影响[J]. 解放军护理杂志, 2021, 38(8):27-30,92.
	Wang JY, Fu C, Xun YY, et al. Effects of different body tem-perature management strategies on cerebral oxygen saturation change rate and postoperative delirium among elderly patients with one-lung ventilation[J]. Nurs J Chin PLA, 2021, 38(8):27-30,92.
[14]	余晖, 宋辉琼, 秦汉, 等. 不同体温管理策略对脊柱外科内固定术患者血脑屏障结构及术后认知功能障碍的影响[J]. 中华麻醉学杂志, 2022, 42(7):818-822.
	Yu H, Song HQ, Qin H, et al. Effects of different temperature management strategies on blood-brain barrier and post-operative cognitive dysfunction in patients undergoing spinal fixation surgery[J]. Chin J Anesthesiol, 2022, 42(7):818-822.

[1]	李鑫, 黎张双子, 崔安妮, 徐傲然, 韩亚贤. 目标体温管理在心搏骤停患者中应用效果的系统评价再评价[J]. 中华急危重症护理杂志, 2025, 6(2): 173-180.
[2]	潘银芝, 杨旻斐. 肝糖原累积病合并脓毒症伴冷凝集现象患者的护理[J]. 中华急危重症护理杂志, 2025, 6(2): 201-203.
[3]	王海燕, 董梦, 祁学峰, 蒋小青, 李婷. 视神经脊髓炎谱系疾病极后区综合征并发呼吸抑制患者的护理[J]. 中华急危重症护理杂志, 2025, 6(2): 204-206.
[4]	杨静, 刘欢, 杜爱平, 尹万红, 田永明. 复杂弥漫性颈部动静脉畸形累及气道致拔管困难患者的护理[J]. 中华急危重症护理杂志, 2025, 6(2): 207-209.
[5]	徐小英, 叶素娟, 吴秋杭, 乔文博, 高春华. 术后患者发生阿片类药物诱导呼吸抑制的评估及预防研究进展[J]. 中华急危重症护理杂志, 2025, 6(2): 252-256.
[6]	宋亚奇, 钟娟平, 程斐然, 任李媛, 左倩倩, 魏政勇, 豆欣蔓. 低价值护理“去实施化”在危重症领域的研究进展[J]. 中华急危重症护理杂志, 2025, 6(1): 65-69.
[7]	北京市体外生命支持质量控制和改进中心/首都医科大学附属北京安贞医院心脏外科危重症中心. 成人体外膜肺氧合循环辅助护理专家共识[J]. 中华急危重症护理杂志, 2025, 6(1): 70-75.
[8]	陈海莲, 邹双, 李程, 王力涵. 重度主动脉瓣狭窄患者急诊行经导管主动脉瓣置换术的围手术期护理[J]. 中华急危重症护理杂志, 2025, 6(1): 79-81.
[9]	胡汉, 冯丹, 何俊峰. 肺癌患者使用免疫检查点抑制剂后发生心脏毒性反应的护理[J]. 中华急危重症护理杂志, 2025, 6(1): 86-88.
[10]	国家儿童健康与疾病临床医学研究中心/浙江大学医学院附属儿童医院护理部首都医科大学附属北京儿童医院护理部复旦大学附属儿科医院护理部上海交通大学医学院附属上海儿童医学中心PICU 重庆医科大学附属儿童医院PICU 广州市妇女儿童医学中心急诊科苏州大学附属儿童医院急诊科宁波妇女儿童医院护理部（执笔：诸纪华刘丽丽胡静陈文琼陶怡余碧艳俞珍岑慧萍陈亚茹李帅妮）. 危重症患儿院际安全转运护理专家共识[J]. 中华急危重症护理杂志, 2024, 5(9): 825-829.
[11]	丁锦玲杨蕾沈晓姜霞娟. 肝癌患者免疫治疗后发生免疫性肠炎致脓毒性休克的护理[J]. 中华急危重症护理杂志, 2024, 5(9): 830-833.
[12]	兰旭红郭龙飞彭彩丽蒋由飞汤雪梅张丽琴傅彩虹郑小明周红芳张志刚. 地震伤员气管切开后早期拔管的护理实践[J]. 中华急危重症护理杂志, 2024, 5(9): 837-839.
[13]	李晓艳李帅妮李冉唐晓敏. 肺动脉闭锁根治及体肺侧支融合患儿的术后护理[J]. 中华急危重症护理杂志, 2024, 5(9): 840-842.
[14]	鲍向英曾妃兰美娟. 先天性肺动静脉瘘患儿行双肺移植术的护理[J]. 中华急危重症护理杂志, 2024, 5(9): 843-845.
[15]	闻莉姚晓燕包祺. 肝硬化失代偿期患者皮肤感染致脓毒性休克的护理[J]. 中华急危重症护理杂志, 2024, 5(9): 846-848.