前列腺电切术后寒战的危险因素分析及防治策略研究  

Analysis of Risk Factors and Prevention and Treatment Strategies for Shivering After Prostatectomy

作　　者：周辉 宋水涛 Zhou Hui;Song Shuitao(Anesthesia Department,Xinyang 154 Hospital of Rongtong Group,Xinyang,Henan,464000,China)

机构地区：[1]融通集团信阳154医院麻醉科,河南信阳464000 [2]信阳一五四医院麻醉科,河南信阳464000

出　　处：《黑龙江医学》2024年第23期2835-2838,共4页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关项目(LHGJ202011228)。

摘　　要：目的:分析前列腺电切术(TURP)术后寒战发生的危险因素,探讨具体防治措施。方法:回顾性分析2021年1月—2022年6月融通集团信阳154医院收治的125例TURP手术患者临床资料,归纳TURP术后寒战发生的危险因素,制定具体防治策略。结果:年龄<45岁、合并心血管病、术前焦虑自评量表(SAS)评分≥50分、抑郁自评量表(SDS)评分≥52分、社会再适应评定量表(SRRS)评分≥150分、术前视觉模拟量表(VAS)评分≥3分、术中中心体温≤36.0℃、手术时间≥1 h、术中出血量≥60 mL、冲洗后钠离子(Na+)≤135 mmol/L、钾离子(K+)≤3.5 mmol/L、术中平均动脉压(MAP)≤70 mmHg为导致TURP术后寒战发生的危险因素(OR=5.325、5.229、6.325、6.321、5.336、5.161、5.339、5.772、6.033、6.255,P<0.05)。结论:年龄较小且合并心血管病的TURP患者可因术前不良心理、疼痛及术中体温偏低、手术时间过长、出血量过大及电解质、体征紊乱等相关因素而发生术后寒战,术前心理干预、疼痛管理,术中保温措施、体征监测为防治术后寒战的重要举措。Objective:To analyze the risk factors of postoperative chills after TURP,and to discuss the specific prevention and treatment measures.Methods:The clinical data of 154 patients undergoing TURP operation in Xinyang 154 Hospital of Rongtong Group from January 2021 to June 2022 were retrospectively analyzed,the risk factors of postoperative chills were summarized.The specific prevention and treatment strategies were formulated.Results:Age<45 years old,combined cardiovascular disease,preoperative self-rating Anxiety Scale(SAS)score≥50 points,self-rating Depression Scale(SDS)score≥52 points,Social Readmission Rating Scale(SRRS)score≥150 points,preoperative visual analogue pain scale(VAS)score≥3 points,intraoperative central temperature≤36.0℃,operation time≥1 h,intraoperative blood loss≥60 mL,sodium ion(Na+)≤135 mmol/L after irrigation,potassium ion(K+)≤3.5mmol/L,and intraoperative mean arterial pressure(MAP)≤70mmHg were the risk factors for postoperative shivering after TURP(OR=5.325,5.229,6.325,6.321,5.336,5.161,5.339,5.772,6.033,6.255;P<0.05).Conclusion:In young patients with TURP complicated with cardiovascular disease,postoperative chills may occur due to preoperative adverse psychology,pain,intraoperative hypothermia,prolonged operation time,excessive blood loss,electrolyte and sign disorders.Preoperative psychological intervention,pain management,intraoperative heat preservation measures,and physical signs monitoring are important measures to prevent and treat postoperative chills.

关 键 词：前列腺电切术 术后寒战 危险因素 防治策略 

分 类 号：R614[医药卫生—麻醉学]