高龄腹部大手术患者术中低体温影响因素及其预防管理  

Influencing factors and preventive management for intraoperative hypothermia in elderly patients undergoing major abdominal surgery

作　　者：崔志勇 孔晓宇 万旭娜 Cui Zhiyong;Kong Xiaoyu;Wan Xuna(Department of Anaesthesiology,No.964 Hospital of Joint Logistics Support Force of Chinese PLA,Changchun 130062,China;Department of Nursing,No.964 Hospital of Joint Logistics Support Force of Chinese PLA,Changchun 130062,China)

机构地区：[1]中国人民解放军联勤保障部队第九六四医院麻醉科,长春130062 [2]中国人民解放军联勤保障部队第九六四医院护理部,长春130062

出　　处：《中华老年多器官疾病杂志》2024年第5期332-335,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：吉林省科技厅科技发展计划项目(20190304116YY)。

摘　　要：目的 调查高龄腹部大手术患者术中低体温发生率,分析影响术中低体温的相关因素。方法 将2022年1月至2023年1月在中国人民解放军联勤保障部队第九六四医院收治的146例行腹部大手术的高龄患者纳为研究对象。统计其术中低体温发生率及术中低体温对患者术后并发症的影响,采用logistic回归模型分析影响高龄腹部大手术患者术中低体温的相关影响因素。采用SPSS 22.0统计软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ^(2)检验。结果 146例高龄腹部大手术患者中,发生术中低体温患者共76例(52.05%),发生术中低体温患者麻醉恢复期寒颤、代谢性酸中毒、电解质紊乱等发生率均高于正常体温组,差异均有统计学意义(P<0.05)。二元logistic回归分析发现,体质量指数≥24 kg/m~2(OR=0.212, 95%CI 0.073~0.615)及输液加温(OR=0.459, 95%CI 0.279~0.756)是高龄腹部大手术患者术中低体温发生的保护因素,而麻醉时间≥3 h(OR=2.010, 95%CI 1.604~2.518)、术中输液量>2 000 ml(OR=1.912,95%CI 1.164~3.139)是其危险因素。结论 高龄腹部大手术患者术中低体温发生率较高,术中低体温会增加患者术后各种并发症发生率;建议采用复合措施,以降低患者术中低体温发生率。Objective To investigate the incidence rate of intraoperative hypothermia in elderly patients undergoing major abdominal surgery and analyze the related factors for intraoperative hypothermia.Methods A total of 146 elderly patients who underwent major abdominal surgery in our hospital between January 2022 and January 2023 were recruited as the study subjects.The incidence of intra-operative hypothermia and its impact on postoperative complications were statistically analyzed.Logistic regression model was used to analyze the related influencing factors for intraoperative hypothermia in elderly patients undergoing major abdominal surgery.SPSS statistics 22.0 was employed for statistical analysis.Data comparison between two groups was performed using student′s t test or Chi-square test depending on data type.Results Among the 146 subjected patients,76 cases(52.05%)experienced intraoperative hypothermia.The incidence rates of shivering during anesthesia recovery,metabolic acidosis and electrolyte disturbance were significantly higher in patients with intraoperative hypothermia than those with normal body temperature(P<0.05).Binary logistic regression analysis showed that body mass index≥24 kg/m 2(OR=0.212,95%CI 0.073-0.615)and warming infusion solutions(OR=0.459,95%CI 0.279-0.756)were protective factors,and anesthesia time≥3 h(OR=2.010,95%CI 1.604-2.518)and intraoperative infusion volume>2000 ml(OR=1.912,95%CI 1.164-3.139)were risk factors for intraoperative hypothermia in elderly patients with major abdominal surgery.Conclusion The incidence of intraoperative hypothermia is high among elderly patients undergoing major abdominal surgery,and it will increase the incidence rates of various postoperative complications.It is suggested that clinical composite measures should be adopted to reduce the incidence rate of intraoperative hypothermia.

关 键 词：老年人 术中低体温 腹部大手术 危险因素 

分 类 号：R572[医药卫生—消化系统] R614.2[医药卫生—内科学]