剖宫产产妇术后手术源性低体温风险预测模型的构建及应用  

Construction and application of risk prediction model for surgically derived hypothermia of parturients after cesarean

作　　者：谢芳婷 鲍洁[1] 许波静 邹逸帆 XIE Fangting;BAO Jie;XU Bojing;ZOU Yifan(The First Affiliated Hospital of Nanjing Medical University(Jiangsu Provincial Peoples Hospital),Nanjing,Jiangsu Province,210029;The Second Affiliated Hospital of Nanjing Medical University)

机构地区：[1]南京医科大学第一附属医院(江苏省人民医院),210029 [2]南京医科大学第二附属医院

出　　处：《中国计划生育学杂志》2023年第4期944-948,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨剖宫产产妇发生术后手术源性低体温风险的影响因素,并构建列线图预测模型。方法:回顾性分析2020年2月-2021年9月本院实施剖宫产并发生术后手术源性低体温的196例产妇作为低体温组,非低体温的196例产妇作为对照组,比较两组资料差异,采用单因素和多因素分析筛选出影响CD产妇发生术后手术源性低体温风险的独立危险因素,绘制列线图并进行验证。结果:多因素logistic回归分析表明,甲状腺功能减退、麻醉方式为腰麻、麻醉后体温<36.75℃、术中冲洗腹腔液体量>800 ml、术中产妇体液丢失量>980ml、未采取主动保温、未采取输液加温及进入手术室室温≤23℃是影响剖宫产产妇麻醉中低体温的独立危险因素(P<0.05)。结论:初步确定了剖宫产产妇麻醉中低体温的8个独立危险因素;基于这些因素绘制的列线图对预测CD产妇术后手术源性低体温具有良好的准确性,对预防母体体温过低具有临床指导价值。Objective:To investigate the influencing factors of the risk of postoperative surgically derived hypothermia of parturients after cesarean,and to construct the nomogram prediction model.Methods:The clinical data of 196 par-turients with postoperative surgically derived hypothermia after cesarean(in study group)from February 2020 to Sep-tember 2021 were analyzed retrospectively.196 parturients without postoperative surgically derived hypothermia after cesarean were selected in control group.The difference of the data of the parturients was compared between the two groups.The independent risk factors affecting the risk of the postoperative surgically derived hypothermia parturients after the cesarean were screened by univariate and multivariate analysis,and then the Nomograms model were drawn and were validated.Results:The results of multivariate Logistic regression analysis showed that the hypothyroidism,the spinal anesthesia,the temperature after anesthesia<:36.75 C,the volume of peritoneal fluid flushed during sur-gery>800 ml,the volume of body fluid lost during surgery>980 ml,no active insulation measure,no warm fluids of transfusion,and the room temperature≤23C were all the independent risk factors of hypothermia of the parturients after cesarean(P<0.05).Conclusion:8 independent risk factors of hypothermia of the parturients after cesarean were identified in this study,and the Nomograms drawn based on these factors has good accuracy for predicting the surgical-ly derived hypothermia of the parturients after cesarean,and which has clinical value for preventing the maternal hypo-thermia.

关 键 词：剖宫产 手术源性 低体温风险 列线图预测模型 

分 类 号：R719.8[医药卫生—妇产科学]