Henker R A, Brown S D, Marion D W
Department of Acute/Tertiary Care, School of Nursing, University of Pittsburgh, Pennsylvania, USA.
Neurosurgery. 1998 May;42(5):1071-5. doi: 10.1097/00006123-199805000-00071.
The purpose of this study was to compare brain temperature (Tbr) with conventional indicators of core body temperature (i.e., rectal temperature [Tre] and bladder temperature [Tbl]), in adults with severe head injury.
The relationships between Tbr and Tbl and between Tbr and Tre are described in terms of differences in temperature in eight patients with severe head injury.
Brain tissue temperature was measured every minute, with a thermocouple embedded 2 cm from the tip of a ventriculostomy catheter used to measure intracranial pressure. Tbl was measured with a thermistor embedded in a bladder catheter, and Tre was measured with a thermistor in a rectal probe.
Tbr was usually greater than Tbl and Tre. The average difference between Tbr and Tbl for each patient ranged from 0.32 to 1.9 degrees C, with standard deviations of the difference ranging from 0.30 to 0.80 degrees C. The average difference between Tbr and Tre for each patient ranged from 0.1 to 2.0 degrees C, with standard deviations of the difference ranging from 0.32 to 1.08 degrees C. In the majority of patients, the differences (Tbr - Tbl and Tbr - Tre) were greater at temperatures outside of the normal temperature range (Tbr < or =36 degrees C and >38 degrees C).
Tbl and Tre often underrepresent Tbr after traumatic brain injury, particularly when the patient is hypo- or hyperthermic.
本研究旨在比较重度颅脑损伤成年患者的脑温（Tbr）与传统核心体温指标（即直肠温度[Tre]和膀胱温度[Tbl]）。
通过描述8例重度颅脑损伤患者的温度差异，阐述Tbr与Tbl之间以及Tbr与Tre之间的关系。
使用埋入距脑室造瘘导管尖端2 cm处的热电偶每分钟测量一次脑组织温度，该导管用于测量颅内压。Tbl通过埋入膀胱导管的热敏电阻测量，Tre通过直肠探头中的热敏电阻测量。
Tbr通常高于Tbl和Tre。每位患者Tbr与Tbl的平均差值在0.32至1.9摄氏度之间，差值的标准差在0.30至0.80摄氏度之间。每位患者Tbr与Tre的平均差值在0.1至2.0摄氏度之间，差值的标准差在0.32至1.08摄氏度之间。在大多数患者中，在正常体温范围之外（Tbr≤36摄氏度和＞38摄氏度）时，（Tbr - Tbl和Tbr - Tre）的差值更大。
创伤性脑损伤后，Tbl和Tre常常不能准确反映Tbr，尤其是当患者体温过低或过高时。
