老年绞窄性小肠梗阻患者术中体温水平对患者预后的影响  

Effect of intraoperative temperature level on patient outcome in elderly patients with strangulated small bowel obstruction

作　　者：吴娟 徐林霞 李显蓉 Wu Juan;Xu Linxia;Li Xianrong(Department of Gastrointestinal Surgery,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院胃肠外科,泸州646000

出　　处：《中国实用护理杂志》2023年第15期1128-1133,共6页Chinese Journal of Practical Nursing

基　　金：四川省省级科技计划项目(2020JDKP0095);西南医科大学校级科研项目(2020 ZRQNB053)。

摘　　要：目的探讨老年绞窄性小肠梗阻患者术中体温水平对患者预后的影响。方法本研究为回顾性分析,便利抽样法选取西南医科大学附属医院2017年12月至2022年6月收治的113例绞窄性小肠梗阻并行小肠部分切除吻合术的老年患者为研究对象,分析其临床资料。ROC曲线分析术中体温水平(T)与患者预后的关系,获得最佳截断点(Ta)。根据T与Ta之间的关系,将所有患者分为低体温组33例(T<Ta)和高体温组80例(T≥Ta),比较2组预后的差异并应用Logistic回归法分析预后的影响因素。结果ROC曲线的Ta为36.45℃。低体温组术后并发症发生率为60.6%(20/33),高于高体温组的6.3%(5/80),差异有统计学意义(χ^(2)=40.06,P<0.01)。Logistic回归方法进行多因素分析发现小肠穿孔、术中体温水平低是手术预后的危险因素(OR=9.874,95%CI 1.260~77.400;OR=69865.637,95%CI 90.799~53758097.700,均P<0.05)。结论老年绞窄性小肠梗阻患者术中体温水平是手术预后的影响因素。术中体温低于36.45℃提示患者术后更容易出现并发症,并且预后更差。老年患者术中需加强体温管理,必要时予以保温、加热毯等护理干预措施。Objective To investigate the effect of intraoperative body temperature on prognosis of elderly patients with strangulated small bowel obstruction.Methods The clinical data of 113 elderly patients with strangulated small intestinal obstruction and perform partial resection and anastomosis admitted to the Affiliated Hospital of Southwest Medical University from December 2017 to June 2022 were retrospectively analyzed.The ROC curve was used to analyze the relationship between the intraoperative body temperature(T)and the prognosis of patients,so as to obtain the optimal cutoff point(Ta).According to the relationship between T and Ta,all patients were divided into hypothermia group(33 cases)(T<Ta)and hyperthermia group(80 cases)(T≥Ta),and the differences in prognosis between the 2 groups were compared and Logistic regression was applied to analyze the influence of prognostic factors.Results The optimal cutoff value(Ta)of ROC curve was 36.45℃.The incidence of postoperative complications in hypothermia group was 60.6%(20/33),higher than 6.3%(5/80)in hyperthermia group(χ^(2)=40.06,P<0.01).Multivariate analysis by Logistic regression revealed that enteric perforation and lower intraoperative body temperature were risk factors for surgical prognosis(OR=9.874,95%CI 1.260-77.400;OR=69865.637,95%CI 90.799-53758097.700,both P<0.05).Conclusions Intraoperative body temperature was a factor affecting surgical prognosis in elderly patients with strangulated small bowel obstruction.The temperature lower than 36.45℃during the operation indicated that the patients were more prone to complications and had worse prognosis.Intensive temperature management was required intraoperatively in elderly patients,and nursing interventions such as warming and heating blankets were necessary.

关 键 词：老年人 肠梗阻 体温水平 术中监测 预后 

分 类 号：R656.7[医药卫生—外科学]