老年患者全身麻醉腹腔镜下子宫切除术中低体温发生情况及危险因素  

Incidence and risk factors of hypothermia in elderly patients undergoing laparoscopic hysterectomy under general anesthesia

作　　者：叶青青 陈悦[1] 吴浩 仲明杰 戴体俊 YE Qing-qing;CHEN Yue;WU Hao;ZHONG Ming-jie;DAI Ti-jun(Department of Anesthesiology,Suqian First People’s Hospital Affiliated to Nanjing Medical University,Suqian Jiangsu 223800,China;Department of Anesthesia and Pharmacology,Xuzhou Medical University,Xuzhou Jiangsu 221004,China)

机构地区：[1]南京医科大学附属宿迁第一人民医院麻醉科,江苏宿迁223800 [2]徐州医科大学麻醉药理学教研室,江苏徐州221004

出　　处：《局解手术学杂志》2023年第2期125-128,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金(30872432)。

摘　　要：目的探讨老年患者全身麻醉腹腔镜下子宫切除术中低体温的发生率及其危险因素。方法选择行全身麻醉腹腔镜下子宫切除术的老年患者187例为研究对象,患者术前均为轻中度贫血,对患者术中低体温的发生情况及危险因素进行分析。结果187例患者中,有65例患者发生了术中低体温,发生率为34.76%。单因素及多因素Logistic回归分析结果显示:年龄≥70岁、术前中度贫血、术中CO_(2)灌注量>200 L、术中CO_(2)气腹时间>120 min及术中腹腔冲洗液量>1500 mL是导致老年患者全身麻醉腹腔镜下子宫切除术中低体温发生的危险因素(OR>1,P<0.05),而术中CO_(2)加温至37℃则是避免发生术中低体温的保护性因素(OR<1,P<0.05)。结论老年患者全身麻醉腹腔镜下子宫切除术中低体温的发生率较高,术中低体温的发生与患者的年龄、术前贫血程度、术中CO_(2)灌注情况、术中CO_(2)气腹时间、术中腹腔冲洗液量及术中CO_(2)加温情况等有关。Objective To explore the incidence and risk factors of hypothermia in elderly patients undergoing laparoscopic hysterectomy under general anesthesia.Methods A total of 187 elderly patients with mild or moderate anemia before operation were selected as the research subjects,who were treated with laparoscopic hysterectomy under general anesthesia,and the incidence and risk factors of intraoperative hypothermia were statistically analyzed.Results Among the 187 elderly patients who underwent laparoscopic hysterectomy under general anesthesia,a total of 65 patients developed intraoperative hypothermia,and the incidence of intraoperative hypothermia was 34.76%.The results of univariate and multivariate Logistic regression analysis showed that age≥70 years old,preoperative moderate anemia,intraoperative CO_(2) perfusion volume>200 L,intraoperative CO_(2) pneumoperitoneum time>20 minutes and intraoperative peritoneal lavage volume>1500 mL were the risk factors for intraoperative hypothermia in the elderly patients undergoing laparoscopic hysterectomy(OR>1,P<0.05),the warming of CO_(2) to 37℃during the operation was a protective factor to avoid the occurrence of intraoperative hypothermia in the elderly patients undergoing laparoscopic hysterectomy(OR<1,P<0.05).Conclusion The incidence of intraoperative hypothermia in elderly patients undergoing laparoscopic hysterectomy under general anesthesia is higher,which is related to the age,the degree of preoperative anemia,the intraoperative CO_(2) perfusion,the intraoperative CO_(2) pneumoperitoneum time,the amount of intraoperative peritoneal lavage fluid and the intraoperative CO_(2) warming.

关 键 词：贫血 全身麻醉 腹腔镜下子宫切除术 术中低体温 老年 

分 类 号：R713.42[医药卫生—妇产科学]