妇科腹腔镜手术患者术中低体温发生率及影响因素分析

Incidence and risk factors of inadvertent intraoperative hypothermia in patients with laparoscopic gynecological surgery

摘要:

目的 探讨妇科腹腔镜手术患者术中低体温发生率及相关影响因素。方法 选取2018年10月－2019年6月就诊于该院妇科行腹腔镜手术的患者383例，收集研究对象人口学、麻醉和手术相关资料，分析术中低体温的相关因素。结果 383例患者中，119例术中体温低于36℃，低体温发生率为31.1%。单因素分析显示与低体温相关的因素包括：①术前因素：年龄≥45岁；②麻醉因素：丙泊酚用量、瑞芬太尼用量和麻醉时间；③手术因素：CO₂注入量、术中冲洗量、静脉总入量、液体总出量和手术室时间。多因素Logistic回归分析显示术中冲洗量（O = 1.746，95%CI：1.079～2.826，P = 0.023）、静脉总入量（O = 2.554，95%CI：1.366～4.773，P = 0.003）和手术室时间（O = 2.058，95%CI：1.107～3.823，P = 0.022）为妇科腹腔镜术中低体温的独立危险因素。结论 妇科腹腔镜手术术中低体温的发生率为31.1%。与术中低体温相关的独立危险因素是冲洗量、静脉总入量和手术室时间。

Abstract:

Objective To investigate the incidence of intraoperative hypothermia and its related factors in patients underwent laparoscopic gynecological surgery.Methods Patients who planned to undergoing laparoscopic surgery from October 2018 to June 2019 were invited. We collected the demographic, anesthesia, and surgical data of the research subjects, and analyze the factors related to hypothermia during the operation.Results In this study, 383 patients were included in the analysis. 119 patients’ core body temperature were lower than 36℃, the incidence rate of hypothermia was 31.1%. Univariate analysis showed that the preoperative factor related to hypothermia: Preoperative factors: age ≥ 45 years; Anesthesia factors: propofol, remifentanil, and duration of anesthesia; Operative factors: CO₂, irrigation, total input volume, total output volume, and duration of operating room. Multivariate Logistic regression analysis showed that the volume of irrigation (O = 1.746, 95%CI: 1.079 ~ 2.826, P = 0.023), total volume of intravenous input (O = 2.554, 95%CI: 1.366 ~ 4.773, P = 0.003) and duration of operating room (O = 2.058, 95%CI: 1.107 ~ 3.823, P = 0.022) were independent risk factors for hypothermia during laparoscopic surgery.Conclusion In laparoscopic gynecological surgery, incidence of hypothermia was 31.1%, and factors independently associated with hypothermia including irrigation, the total volume of intravenous input and the duration of the operating room.