探讨目标体温管理阶梯策略在重症蛛网膜下腔出血（SAH）患者中的应用效果。

回顾性分析徐州医科大学附属沭阳医院2021年9月至2024年10月收治的80例重症SAH患者的临床资料，其中男性51例，女性29例；年龄51~75岁[（65.03±5.31）岁]。以2021年9月至2023年3月接受常规体温管理的38例患者作为对照组，2023年4月至2024年10月接受目标体温（目标温度36℃）管理策略的42例患者作为观察组，两组患者干预时间均为干预至出院前。收集两组患者干预前、干预12、24及48 h后的体温的变化的资料，收集干预前、干预48 h及出院时美国国立卫生研究院卒中量表（NIHSS）评分的资料，并收集两组患者干预前、出院时的亨特-赫斯（Hunt-Hess）分级及并发症发生率的资料。

重复测量方差分析显示，两组患者体温比较组间、时间效应均显著（P<0.05），时间点与组别之间具有交互效应（P<0.05）；Bonferroni法校正进行简单效应分析显示，观察组干预12、24及48 h体温均低于对照组（P<0.05），观察组干预48 h期间目标温度（36℃）达标率高于对照组（P<0.05）；重复测量方差分析显示，两组患者NIHSS评分比较组间、时间效应均显著（P<0.05），时间点与组别之间具有交互效应（P<0.05）；Bonferroni法校正进行简单效应分析显示，观察组干预后48 h、出院时NIHSS评分均低于对照组（P<0.05）；出院时，观察组Hunt-Hess分级优于对照组（P<0.05）；观察组并发症总发生率低于对照组（P<0.05）。

目标体温管理阶梯策略有助于控制重症SAH患者体温，降低并发症发生率，有较好的临床应用价值。

To investigate the application effect of a stepped targeted temperature management strategy in patients with severe subarachnoid hemorrhage (SAH).

Clinical data of 80 patients with severe SAH admitted to Shuyang Hospital Affiliated to Xuzhou Medical University from September 2021 to October 2024 were retrospectively analyzed, including 51 males and 29 females, aged 51~75 years, with a mean age of (65.03±5.31) years. Thirty-eight patients who received conventional temperature management from September 2021 to March 2023 were assigned to the control group, and 42 patients who received the targeted temperature management strategy (target temperature 36 ℃) from April 2023 to October 2024 were assigned to the observation group. Interventions in both patient groups were performed until discharge. Body temperature data were collected before intervention and at 12, 24, and 48 hours after intervention. National Institutes of Health Stroke Scale (NIHSS) scores were recorded before intervention, at 48 hours after intervention, and at discharge. Hunt-Hess grades before intervention and at discharge, as well as the incidence of complications in both patient groups, were also collected.

Repeated-measures analysis of variance showed significant intergroup and temporal effects on body temperature between the two patient groups (P<0.05), with a significant interaction between time points and groups (P<0.05). Simple effect analysis with Bonferroni correction revealed that body temperature in the observation group was lower than that in the control group at 12, 24, and 48 hours after intervention (P<0.05), and the achievement rate of the target temperature (36 ℃) at 48 hours in the observation group was higher than that in the control group (P<0.05). Repeated-measures analysis of variance also showed significant intergroup and temporal effects on NIHSS scores between the two patient groups (P<0.05), with a significant interaction between time points and groups (P<0.05). Simple effect analysis with Bonferroni correction indicated that NIHSS scores in the observation group were lower than those in the control group at 48 hours after intervention and at discharge (P<0.05). At discharge, the Hunt-Hess grade in the observation group was superior to that in the control group (P<0.05), and the total incidence of complications in the observation group was lower than that in the control group (P<0.05).

The stepped targeted temperature management strategy (target temperature 36 ℃) is conducive to controlling body temperature, reducing the incidence of complications in patients with severe SAH, and possesses favorable clinical application value.