Holtzclaw B J
Center for Nursing Research, Vanderbilt University School of Nursing, Nashville, TN.
Oncol Nurs Forum. 1990 Jul-Aug;17(4):521-4.
"Rigors" of febrile shivering often complicate therapy with amphotericin B (AmB) in immunosuppressed patients with cancer. Violent muscle contractions cause physical and emotional distress as well as dread of future therapy. This experimental study tested the effectiveness of a nursing measure in 20 hospitalized adult patients with cancer. In addition, the effects of shivering on myocardial oxygen consumption were studied. Based on Abbey's Model of Nursing Action, wraps of terry cloth toweling were applied to extremities to protect dominant skin sensors against heat loss. Patients with wrapped extremities had shorter, less severe shivering episodes than controls (p = 0.04) and required less meperidine for shivering suppression (p = 0.04). Shivering significantly elevated myocardial oxygen consumption, reflected in the rate pressure product (RPP), above pre- or post-shivering levels (p less than 0.0001). The study reflects first-year findings of a federally funded project.
发热性寒战的“寒战”常常使接受两性霉素B（AmB）治疗的免疫抑制癌症患者的治疗变得复杂。剧烈的肌肉收缩会导致身体和情绪上的痛苦，以及对未来治疗的恐惧。这项实验研究测试了一项护理措施对20名住院成年癌症患者的有效性。此外，还研究了寒战对心肌耗氧量的影响。基于阿比护理行动模型，用毛巾布包裹四肢，以保护主要皮肤感受器防止热量散失。与对照组相比，四肢包裹的患者寒战发作时间更短、程度更轻（p = 0.04），且抑制寒战所需的哌替啶更少（p = 0.04）。寒战显著提高了心肌耗氧量，表现为心率血压乘积（RPP）高于寒战前或寒战后水平（p < 0.0001）。该研究反映了一个由联邦政府资助项目的第一年研究结果。
