消化道肿瘤患者术中低体温的影响因素及干预措施探讨  

Influencing factors and intervention measures of intraoperative hypothermia in patients with gastrointestinal tumors

作　　者：吕丹萍 LYU Dan-ping(Operating Room,Jinjiang Hospital(Shanghai Sixth People's Hospital Fujian Hospital),Jinjiang 362200,China)

机构地区：[1]晋江市医院(上海市第六人民医院福建医院)手术室,362200

出　　处：《中国现代药物应用》2025年第7期51-54,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探究消化道肿瘤患者术中低体温的影响因素及干预措施。方法103例行腹腔镜手术的消化道肿瘤患者,根据术中是否出现低体温将患者分为低温组(n=55)和正常体温组(n=48)。比较两组患者一般资料[年龄、性别、体质量指数(BMI)、肿瘤位置、吸烟史、手术时间、二氧化碳(CO2)总使用量、肿瘤大小、术中输液量、术中失血量、是否中转开腹手术、美国麻醉医师协会(ASA)评分],分析消化道肿瘤患者术中低体温发生的影响因素。结果103例患者发生术中低体温有55例,占比53.40%;正常体温有48例,占比46.60%。经单因素分析显示,低温组患者BMI<24 kg/m^(2)占比67.27%、手术时间≥3 h占比43.64%、CO2总使用量≥200 L占比38.18%、术中输液量≥1500 ml占比34.55%、中转开腹手术占比27.27%均高于正常体温组的43.75%、20.83%、12.50%、8.33%、6.25%(P<0.05)。两组患者年龄、性别、肿瘤位置、吸烟史、肿瘤大小、术中失血量、ASA评分无明显差异(P>0.05)。多因素Logistic回归分析显示,BMI、手术时间、CO2总使用量、术中输液量、中转开腹手术是消化道肿瘤患者术中低体温发生的影响因素(P<0.05)。结论中转开腹手术、BMI<24 kg/m^(2)、手术时间≥3 h、CO2总使用量≥200 L、术中输液量≥1500 ml等因素均会增加消化道肿瘤患者术中低体温的发生风险,临床应根据相关危险因素制定相应的安全、科学的干预措施,包括基础保温干预以及联合其他加温措施,有助于减少低体温的发生,保障患者术中术后安全。Objective To explore the influencing factors and intervention measures of intraoperative hypothermia in patients with gastrointestinal tumors.Methods 103 patients with gastrointestinal tumors undergoing laparoscopic surgery were divided into hypothermia group(n=55)and normothermia group(n=48)according to whether hypothermia occurred during operation.The general data of the two groups was compared,including age,gender,body mass index(BMI),tumor location,smoking history,operation time,total carbon dioxide(CO2)consumption,tumor size,intraoperative infusion volume,intraoperative blood loss,whether conversion to open surgery,and American Society of Anesthesiologists(ASA)score,and the influencing factors for the occurrence of intraoperative hypothermia in patients with gastrointestinal tumors were analyzed.Results In 103 patients,intraoperative hypothermia occurred in 55 patients(53.40%)and normothermia in 48 patients(46.60%).Univariate analysis showed that in the hypothermia group,67.27%of the patients had a BMI<24 kg/m^(2),43.64%had an operation time of≥3 h,38.18%had a total CO2 consumption of≥200 L,34.55%had an intraoperative infusion volume of≥1500 ml,and 27.27%converted to open surgery,all of which were higher than 43.75%,20.83%,12.50%,8.33%and 6.25%in the normothermia group(P<0.05).There were no significant differences in age,gender,tumor location,smoking history,tumor size,intraoperative blood loss and ASA score between the two groups(P>0.05).Multivariate Logistic regression analysis showed that BMI,operation time,total CO2 consumption,intraoperative infusion volume,and conversion to open surgery were the factors affecting the occurrence of intraoperative hypothermia in patients with gastrointestinal tumors(P<0.05).Conclusion Conversion to open surgery,BMI<24 kg/m^(2),operation time≥3 h,total CO2 consumption≥200 L,intraoperative infusion volume≥1500 ml and other factors will increase the risk of intraoperative hypothermia in patients with gastrointestinal tumors;clinical safety and scientific interve

关 键 词：消化道肿瘤 术中低体温 腹腔镜手术 中转开腹手术 

分 类 号：R735[医药卫生—肿瘤]