冰枕與冰毯機對加護病房中顱內損傷發燒病患之降溫效果、舒適情況與影響因素之探討

Temperature Reducing Effectiveness, Patients' Comfortable Levels and Related Factors in Applying Ice Pillow and Thermal Blanket in Hyperthermic Patients with Intracranial Disorders

謝雪貞(Shiue-Jen Shie) ； 邱艷芬(Yann-Fen Chao)

《慈濟醫學雜誌》 10卷2期 (1998/06) Pp. 131-137

https://doi.org/10.6440/TZUCMJ.199806.0131

摘要

本研究是屬於類驗研究法，以較加護病房中腦部損傷或接受顱部手術後發燒患者使用冰枕或冰毯機降低體溫的成效、舒適程度及影響降溫成效之因素。採立意取樣法，先以耳溫槍測量腦部損傷或已接受顱部手術患者之體溫，當核心體溫超過37.9°C未使用解熱劑，而須以冰枕或冰毯機為降溫方式者即為本研究之收案對象。收案後每30分鐘測量一次體體，並觀察皮膚變化及寒顫之情形，此外對意識清醒的患者請他在溫度舒適程度評分表上指出其舒適程度。最後比較冰枕及冰毯機之降溫成效，即體溫降至正常核心體溫所需時間;舒適程度;並分析影響降溫成效因素。
研究結果發現:冰毯機組在三小時內恢復正常體溫的比例較冰枕組高，單位時間內可降低的體溫度數亦明顯高於冰枕組。但二組在舒適程度的比較上並無明顯統計學上差異。本研究所探討的影響降溫成效因素，僅降溫前溫度與降溫成效有關。因此對於腦部損傷及顱部手術後有發燒現象之患者而言，為避免其腦細胞遭受進一步損傷，宜使用冰毯機來協助其恢復正常體溫。(慈濟醫學1998;10:131-137)

關鍵字

發燒 ； 冰枕 ； 冰毯機 ； 降溫成效 ； 降溫舒適程度

並列摘要

Hyperthermia is hazardous for patients with intracranial disorders. We designed a quasi-experimental study to compare the effectiveness, comfort level and confounding factors between ice pillow and thermal blanket for the febrile patients after craniotomy or traumatic brain injury. This is case control study. Sixty-one patients with traumatic brain injury or craniotomy are enrolled in this study. Their body temperature are tested by tympanic thermometer and their core temperature are all higher than 37.9°C. Antipyretic agents were not administered. Participants are divided into two groups. The first group used the ice pillow and the other used the thermal blanket to lower body temperature. Body temperatures of all patients were tested verey 30 minutes after beginning ice pillow or thermal blanket therapy. Skin change and chill are also recorded, Comfort level was eva;uated in alert patients by thermal comfort scale. The effectiveness of these two devieces was analyzed on the basis of time required to decrease the core temperature to within the normal range (36.7-37.9°C) and comfort level. Confounding factors are also discussed.
The core temperature of patients using thermal blanket decreased faster than that of patients using ice pillow. The difference in comfort level between the two groups was not statistically significant. The initial temperature was the only confounding factor. Our findings indicate that the thermal blanket is better than the ice pillow for decreasing the body temperature of patients with traumati brain injury, or after craniotomy.(Tzu Chi Med J1998;10:131-137)

並列關鍵字

hyperthermia ； ice pillow ； thermal blanket ； effectiveness ； comfort level