比較耳溫槍和傳統體溫測量法之正確性

　　　　　本研究主要探討的目的是以肺動脈血溫當標準，使用耳溫槍測量耳溫及 使用水銀溫度計來測量肛溫、腋溫之正確性的比較，並探討冰枕的使用對測量耳 溫的影響。本研究為前瞻性研究。在某醫學中心一般內科加護病房，選取32位因 病情需要而置放肺動脈導管之患者作為研究對象；依序測量腋溫、肛溫、耳溫， 最後並同時記錄各種溫度。結果顯示：坽肺動脈血溫與各種溫度之偏差(bias)， 以耳溫與肺動脈溫最為接近(平均低0.1℃ 0.4℃)，其次是肛溫(平均低0.4℃ 0.4 ℃)，腋溫差距最大(平均低0.8℃ 0.4℃)。夌肺動脈血溫與耳溫、肛溫、腋溫三 者均有很高的相關性(肺動脈血溫與耳溫r = 0.94，與肛溫r = 0.94，與腋溫r = 0.92) 及良好的的一致性(agreement)。奅使用冰枕與否，對肺動脈血溫與耳溫的偏差在 統計上並無顯著差異(p > 0.05)。從本研究結果得知，耳溫槍比傳統體溫測量方法 更能正確反映病人的核心體溫。它不但可以在幾秒內得到測量結果，且使用方 便、沒有侵入性，能有效的節省護理時間，故可以廣泛應用於臨床上。
　　　　　This study was performed to compare the measurements of tympanic temperature, conventional rectal and axillary temperatures with the measurement of pulmonary artery (PA) temperature. The study also investigated the effect of ice pillows on the measurement of tympanic temperature. Thirty-two critical patients requiring PA pressure monitoring were enrolled. Axillary, rectal and tympanic temperatures were recorded sequentially every 4 to 8 hours. PA temperatures were recorded through a PA catheter after completion of the above three kinds of temperature measurement. The means of difference between PA temperature and other temperatures checked were 0.1 0.4℃ for tympanic, 0.4 0.4℃ for rectal, and 0.8 0.4℃ for axillary temperature. There was significant correlation between PA temperature and all three other temperatures (r = 0.94 between PA and tympanic, r = 0.94 between PA and rectal, and r = 0.92 between PA and axillary temperature). There was no significant discrepancy between the differences of PA and tympanic temperatures in patients with or without use of ice pillows. In conclusion, the measurement of tympanic temperature may reflect core temperature more accurately than conventional methods. It is noninvasive, easy to use, and can effect rapid measurements (a few seconds). It can effectively reduce nursing time, so that its extensive application in clinical nursing is warranted.