Devrim Ilker, Kara Ateş, Ceyhan Mehmet, Tezer Hasan, Uludağ Ali Kerem, Cengiz Ali Bülent, Yiğitkanl Inci, Seçmeer Gülten
Pediatric Infectious Disease Unit, Department of Pediatrics, Hacettepe University School of Medicine, Ankara, Turkey.
Pediatr Emerg Care. 2007 Jan;23(1):16-9. doi: 10.1097/PEC.0b013e31802c61e6.
As the basic sciences develop, temperature measurement methods and devices were improved. For hundreds of years both in clinics and home, mercury-in-glass thermometer was the standard of human temperature measurements. In this study, we aimed to compare tympanic infrared thermometers with the conventional temperature option, mercury-in-glass thermometer, which is historical standard in the clinical conditions.
A total of 102 randomly selected pediatric patients who admitted to our hospital were enrolled, and simultaneous temperature measurements were performed via axilla and external auditory canal with 3 different techniques. For external auditory recordings, infrared tympanic First Temp Genius for clinical use and Microlife IR 1DA1 for home usage were used. Classic mercury-in-glass thermometers were used for axillary recording. For each method, 886 measurements were performed.
The mean results of the axillary mercury-in-glass thermometers, infrared tympanic First Temp Genius, and Microlife IR 1DA1 were 36.8 +/- 0.7, 37.5 +/- 0.9, 36.9 +/- 0.8, respectively. The Bland-Altman plot of differences suggests that 95% of the infrared tympanic clinical use thermometer readings were within the limits of agreement, which is +0.27 and -1.75 degrees C range of mercury-in-glass thermometer. The Bland-Altman plot of differences suggests that 95% of the tympanic home-use thermometer readings were within the limits of agreement, which is +0.98 and -1.27 degrees C range of mercury-in-glass thermometer. In our group, 15% of the patients were misdiagnosed as febrile with home-use tympanic thermometer, whereas this percentage was 4% with clinical tympanic thermometer. Also, 5% and 31% of febrile patients were misdiagnosed as afebrile with clinical tympanic and home-use tympanic thermometer, if axillary mercury-in-glass thermometer recording defines fever.
Our results showed that there is a significant difference in each recording with different thermometers, and this variance was present in both higher and lower readings. We recommend thathome-use infrared tympanic thermometer could be used for screening but must not be considered as a tool to decide patients follow-up.
随着基础科学的发展,体温测量方法和设备得到了改进。数百年来,在诊所和家庭中,玻璃水银温度计一直是人体体温测量的标准。在本研究中,我们旨在比较鼓膜式红外体温计与传统体温测量工具——玻璃水银温度计(临床环境中的历史标准)。
共纳入102例随机选取的我院住院儿科患者,采用3种不同技术同时通过腋窝和外耳道进行体温测量。对于外耳道记录,使用临床用的红外鼓膜式First Temp Genius和家用的Microlife IR 1DA1。经典的玻璃水银温度计用于腋窝记录。每种方法均进行了886次测量。
玻璃水银体温计腋窝测量、红外鼓膜式First Temp Genius和Microlife IR 1DA1的平均结果分别为36.8±0.7、37.5±0.9、36.9±0.8。差异的Bland-Altman图表明,95%的红外鼓膜临床用体温计读数在一致性界限内,即相对于玻璃水银温度计为+0.27至-1.75摄氏度范围。差异的Bland-Altman图表明,95%的鼓膜家用体温计读数在一致性界限内,即相对于玻璃水银温度计为+0.98至-1.27摄氏度范围。在我们的研究组中,15%的患者使用家用鼓膜体温计被误诊为发热,而使用临床鼓膜体温计这一比例为4%。此外,如果以腋窝玻璃水银体温计记录定义发热,5%和31%的发热患者使用临床鼓膜体温计和家用鼓膜体温计被误诊为不发热。
我们的结果表明,不同体温计的每次记录存在显著差异,且这种差异在较高和较低读数中均存在。我们建议,家用红外鼓膜体温计可用于筛查,但绝不能被视为决定患者后续治疗的工具。