房颤冷冻消融术患者术中低体温风险评估与危险因素分析  

Risk Assessment and Risk Factor Analysis of Intraoperative Hypothermia in Patients with Atrial Fibrillation Cryoablation

作　　者：童晓珊 王咏梅[1] 金建芬[1] 孟莎莎[1] 沈芸[1] 顾俊杰[1] TONG Xiao-shan;WANG Yong-mei;JIN Jian-fen;MENG Sha-sha;SHEN Yun;GU Jun-jie(Hangzhou First People’s Hospital)

机构地区：[1]杭州市第一人民医院

出　　处：《医院管理论坛》2022年第10期10-14,共5页Hospital Management Forum

基　　金：2020年浙江省医药卫生科技计划面上项目,编号:2020KY208。

摘　　要：目的探讨房颤冷冻消融术患者术中发生低体温的危险因素,并建立风险预测模型。方法选取行房颤冷冻消融术的139例患者作为研究对象,根据术中是否发生低体温,分为低体温组42例和正常体温组97例。对两组患者临床资料进行单因素和二元Logistic回归分析术中低体温发生独立危险因素并得出回归方程。结果年龄增加、低BMI、进入手术室时体温≤36.5℃及手术时间延长是术中发生低体温的独立危险因素(p<0.05)。最终预测模型为P=1/[1+e^(-17.015+0.160age-0.3BMI+2.472temperature+0.116operation time)]。上述变量的曲线下面积(area under curve,AUC)分别为0.791、0.827、0.741和0.778,四项指标联合预测AUC为0.953,较单个指标显著提升(p<0.05)。结论高龄和低BMI患者术中具有发生低体温的风险,对该类患者在术前应做好体温保护措施,同时尽量缩短手术时间,以降低术中低体温的发生。Objective To discuss the risk factors of intraoperative hypothermia in patients with atrial fibrillation cryoablation,and establish a risk prediction model.Methods A total of 139 patients who underwent atrial fibrillation cryoablation were selected as the research subjects.According to whether hypothermia occurred during the operation,they were divided into a hypothermia group of 42 cases and a normothermia group of 97 cases.Univariate and binary logistic regression analysis was performed on the clinical data of the two groups to analyze the independent risk factors for intraoperative hypothermia and obtain the regression equation.Results Senior age,low BMI,body temperature≤36.5℃when entering the operating room and prolonged operation time were independent risk factors for intraoperative hypothermia(p<0.05).The final prediction model is P=1/[1+e^(-17.015+0.160age-0.3BMI+2.472temperature+0.116operation time)].The AUC of the above variables were 0.791,0.827,0.741 and 0.778 respectively,and the combined prediction of the four indicators was 0.953,which was significantly higher than that of a single indicator(p<0.05).Conclusion Patients with senior age and low BMI are at risk of hypothermia during surgery.For these patients,body temperature protection measures should be taken before surgery,and the operation time should be shortened as much as possible to reduce the occurrence of hypothermia during surgery.

关 键 词：心房颤动 冷冻消融术 危险因素 LOGISTIC回归分析 

分 类 号：R197.3[医药卫生—卫生事业管理]