Pediatric Infection and Vaccine

  • 제17권2호
  • /
  • Pages.114-121
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  • 2010
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
권호 표지

중이염과 귀지가 고막 체온에 미치는 영향

Effect of Otitis Media and Cerumen Occlusion on Body Temperature Measured by Thermometers

  • 정성남 (광주기독병원 소아청소년과) ;
  • 김은성 (광주기독병원 소아청소년과) ;
  • 유주희 (광주기독병원 소아청소년과) ;
  • 조형민 (광주기독병원 소아청소년과) ;
  • 유은정 (광주기독병원 소아청소년과) ;
  • 김은영 (광주기독병원 소아청소년과) ;
  • 김경심 (광주기독병원 소아청소년과) ;
  • 김용욱 (광주기독병원 소아청소년과)
  • Jeong, Seong Nam (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Kim, Eun Sung (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • You, Ju Hee (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Cho, Hyung Min (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Yoo, Eun Jung (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Kim, Eun Young (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Kim, Kyoung Sim (Department of Pediatrics, Kwang-ju Christian Hospital) ;
  • Kim, Yong Wook (Department of Pediatrics, Kwang-ju Christian Hospital)
  • 투고 : 2010.08.25
  • 심사 : 2010.10.17
  • 발행 : 2010.12.25
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초록

목적 : 고막체온계는 신체내의 점막과 접촉 없이 고막을 통해 심부체온을 신속히 간편한 방법으로 측정할 수 있어 영아와 소아들에서 많이 사용된다. 본 연구에서는 한쪽에만 중이염, 귀지가 있는 경우 양쪽 고막체온이 어떻게 달라지는지 연구하였다. 방법 : 2008년 6월부터 9월까지, 2010년 1월부터 5월까지 본원 소아청소년과 외래에 내원한 소아 중 비디오 이경을 통해 중이염과 귀지가 없는 정상군 50명, 한쪽에만 고막이 안보이게 귀지가 가득 있는 군 50명, 한쪽에만 중이염을 가진 군 186명의 3개 군을 대상으로 하였다. 고막체온은 Braun Thermoscan을 이용해 양쪽 귀에서 2초간 측정하였고, 15분 뒤 다시 측정하였다. 중이염을 가진 군은 비디오 이경으로 확인하여 염증정도에 따라 분류하여 비교하였다. 통계처리는 SPSSWIN 12.0을 사용하였고 paired T-test와 one way anova를 이용하여 분석하였다. 결과 : 정상 군과 한쪽에만 귀지가 있는 군에서는 양쪽 고막체온의 통계적인 차이는 없었다. 한쪽에만 중이염이 있는 군에서는 중이염이 있는 쪽의 고막이 평균 $0.13{\pm}0.20^{\circ}C$ 높았고 통계적인 차이가 있었다($36.99{\pm}0.54^{\circ}C$ vs $36.86{\pm}0.52^{\circ}C$ P<0.001). 중이염의 단계에 따른 양쪽 고막의 체온차이는 통계적으로 유의하지 않았다. 결론 : 고막체온계는 스트레스 없이 쉽고 빠르게 체온을 측정할 수 있다. 적절한 방법으로 측정한다면 양측 고막체온에는 큰 차이가 없을 것으로 생각되나, 중이염이 있을 때엔 양쪽 고막체온에 차이가 있을 수 있음을 주의 해야겠다.

Purpose : To examine the effect of unilateral otitis media and unilateral cerumen occlusion of the ear canal on thermometers. Methods : One hundred eighty six children with unilateral otitis media, fifty children with unilateral cerumen occlusion, and fifty children with neither otitis media nor cerumen were enrolled. Temperature was measured in both ear canals using thermometers. After 15 minutes, second temperature was measured again in both ears. Unilateral otitis media was graded by video otoscope for 7 grades. Differences in temperatures between affected ears and unaffected ears were analyzed. Results : No temperature difference between the normal and cerumen groups was observed. The mean temperature of the otitis media ear canal was $0.13{\pm}0.20^{\circ}C$ higher than that of the intact ear canal ($36.99{\pm}0.54^{\circ}C$ vs $36.86{\pm}0.52^{\circ}C$; P<0.001). There was no statistically significant temperature difference between grades. Conclusion : Unilateral otits media can affect estimation of body temperature measured by thermometers.

키워드

참고문헌

  1. Benzinger TH. Clinical temperature: new physiological basis. JAMA 1969;209:1200-6. https://doi.org/10.1001/jama.209.8.1200
  2. Childs C, Harrison R, Hodkinson C. Tympanic membrane temperature as a measure of core temperature. Arch Dis Child 1999;80:262-6. https://doi.org/10.1136/adc.80.3.262
  3. Edge G, Morgan M. The genius infrared tympanic thermometer. An evaluation for clinical use. Anesthesia 1993;48:604-7. https://doi.org/10.1111/j.1365-2044.1993.tb07127.x
  4. Schmit, B.D. Behavioral aspects of temperature-taking. proceedings of the symposium 'Fever and tympanic thermometry'. Clinical Pediatrics 1991;30:8-10.
  5. Silverman BG, Daley WR, Rubin JD. The use of infrared ear thermometers in pediatric and family practice offices. Public Health Rep 1998;113:268-72.
  6. Erickson RS, Woo TM. Accuracy of infrared ear thermometry and traditional temperature methods in young children. Heart Lung 1994;23:181-95.
  7. Doezema D, Lunt M, Tandberg D. Cerumen occlusion lowers infrared tympanic membrane temperature measurement. Acad Emerg Med 1995;2:17-9. https://doi.org/10.1111/j.1553-2712.1995.tb03072.x
  8. García Callejo FJ, Platero Zamarreno A, Sebastian Gil E, Marco Sanz M, Alpera Lacruz RJ, Martinez Beneyto MP. Otologic determining factors on infra-red tympanic thermometry in children. Acta Otorrinolaringol Esp 2004; 55:107-13. https://doi.org/10.1016/S0001-6519(04)78492-7
  9. Modell JG, Katholi CR, Kumaramangalam SM, Hudson EC, Graham D. Unreliability of the infrared tympanic thermometer in clinical practice: a comparative study with oral mercury and oral electronic thermometers. South Med J 1998;91:649-54. https://doi.org/10.1097/00007611-199807000-00008
  10. Rohrberg M, Fritz U, Weyland W, Braun U. Temperature measurement in the ear canal: comparison of an infrared thermometer with conventional temperature probes and evaluation of clinical factors on infrared measurement Anasthesiol Intensivmed Notfallmed Schmerzther 1997; 32:409-13. https://doi.org/10.1055/s-2007-995081
  11. Kenney RD, Fortenberry JD, Surratt SS, Ribbeck BM, Thomas WJ. Evaluation of an infrared tympanic membrane thermometer in pediatric patients. Pediatrics 1990; 85:854-8.
  12. Pandey A, Ingrams DR, Jones M, Raman R, Marks ND. Reliability of a tympanic thermometer in measuring temperatures in children after minor ear surgery. The Journal of Laryngology & Otology 2006;120:375-7.
  13. Mandell DL, Pearl AW, Rothschild MA. Influence of minor ear surgery on infrared tympanic thermometry. Arch Otolaryngol Head Neck Surg 2001;127:547-52. https://doi.org/10.1001/archotol.127.5.547
  14. Frank Schmal, Marjolein Loh-van den Brink, Wolfgang Stoll. Effect of the status after ear surgery and ear pathology on the results of infrared tympanic thermometry. Eur Arch Otorhinolaryngol 2006;263:105-10. https://doi.org/10.1007/s00405-005-0966-6
  15. Huang HP, Shih HM. Use of infrared thermometry and effect of otitis externa on external ear canal temperature in dogs. J Am Vet Med Assoc 1998;213:76-9.
  16. Fisch RO, Eaton BG, Geibink GS. Tympanic membrane temperature during experimental otitis media due to Streptococcus pneumoniae in chinchillas. Lab Anim Sci 1982;32:278-9.
  17. Kelly B, Alexander D. Effect of otitis media on infrared tympanic thermometry. Clin Pediatr (Phila) 1991;30:46- 8. https://doi.org/10.1177/000992289103000413
  18. Jolin SW, Howell JM, Milzman DP, Stair TO, Butzin CA. Infrared emission detection tympanic thermometry may be useful in diagnosing acute otitis media. Am J Emerg Med 1995;13:6-8. https://doi.org/10.1016/0735-6757(95)90230-9
  19. Weir MR, Weir TE. Are "hot" ears really hot? Am J Dis Child 1989;143:763-4.
  20. Jang CH, Kim YH. Clinical Usefulness of Temperature of Tympanic Membrane in Diagnosing Unilateral Acute Suppurative Otitis Media. Korean J Otolaryngol 2000; 43:715-8.
  21. Friedman NR, McCormick DP, Pittman C, Chonmaitree T, Teichgraeber DC, Uchida T, et al. Development of a practical tool for assessing the severity of acute otitis media. Pediatr Infect Dis J 2006;25:101-7. https://doi.org/10.1097/01.inf.0000199290.73333.89
  22. Craig JV, Lancaster GA, Taylor S, Williamson PR, Smyth RL. Infrared ear thermometry compared with rectal thermometry in children: a systematic review. Lancet 2002;360:603-9. https://doi.org/10.1016/S0140-6736(02)09783-0
  23. Dodd SR, Lancaster GA, Craig JV, Smyth RL, Williamson PR. In a systematic review, infrared ear thermometry for fever diagnosis in children finds poor sensitivity. J Clin Epidemiol 2006;59:354-7. Epub 2006 Feb 20. https://doi.org/10.1016/j.jclinepi.2005.10.004
  24. Smitz S, Van de Winckel A, Smitz MF. Reliability of infrared ear thermometry in the prediction of rectal temperature in older inpatients. J Clin Nurs 2009;18:451-6. https://doi.org/10.1111/j.1365-2702.2008.02565.x
  25. Smitz S, Giagoultsis T, Dewé W, Albert A. Comparison of Rectal and Infrared Ear Temperature in Older Hospital Inpatients. J Am Geriatr Soc 2000;48:63-6. https://doi.org/10.1111/j.1532-5415.2000.tb03030.x
  26. El-Radhi AS, Patel S. An evaluation of tympanic thermometry in a paediatric emergency department. Emerg Med J 2006;23:40-1. https://doi.org/10.1136/emj.2004.022764
  27. Sung HK, Lee SD. Physiology. 5th ed. Seoul:Wihak co, 1991:339-43.
  28. Uddman R, Kitajiri M, Sundler F. Autonomic innervation of the middle ear. Ann Otol Rhinol Laryngol 1983;92: 151-4. https://doi.org/10.1177/000348948309200211