全麻下腹腔镜子宫切除术患者术中低体温发生的风险因素与其干预措施分析

Risk factors and intervention measures of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia

目的:分析全麻下腹腔镜子宫切除术患者术中低体温发生的风险因素与其干预措施。方法:回顾性纳入2022年1月―2023年1月在南京医科大学第一附属医院收治行全麻下腹腔镜子宫切除术的患者共408例,依据患者术中是否出现低体温情况分为发生术中低体温组51例、未发生术中低体温组357例。统计患者一般资料并进行全麻下腹腔镜子宫切除术患者发生术中低体温的单因素分析,采用多因素Logistic回归分析影响全麻下腹腔镜子宫切除术患者发生术中低体温的相关因素。结果:单因素分析结果显示,发生术中低体温组中年龄高于未发生术中低体温组,麻醉时间、手术时间则长于未发生术中低体温组,补液量、二氧化碳用量、出血量则均多于未发生术中低体温组,差异有统计学意义;多因素Logistic分析结果显示,麻醉时间≥90 min、手术时间≥120 min、补液量≥2000 mL、二氧化碳用量≥150 L、出血量≥100 mL均为影响全麻下腹腔镜子宫切除术患者发生术中低体温的风险因素。结论:影响全麻下腹腔镜子宫切除术患者发生术中低体温的风险因素包括有麻醉时间≥90min、手术时间≥120 min、补液量≥2000 mL、二氧化碳用量≥150 L、出血量≥100 mL,临床可据此对全麻下腹腔镜子宫切除术患者进行针对性干预以降低患者术中低体温发生的风险。

Objective To analyze the risk factors and intervention measures of hypothermia during laparoscopic hysterectomy under general anesthesia.Methods A total of 408 patients who underwent laparoscopic hysterectomy under general anesthesia in the First Affiliated Hospital of Nanjing Medical University from January 2022 to January 2023 were retrospectively included.According to whether there was hypothermia during the operation,they were divided into two groups:51 patients of the group with intraoperative hypothermia and 357 patients of the group without intraoperative hypothermia.The general data of patients were counted,and the single factor analysis of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia was carried out.The related factors affecting the occurrence of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia were analyzed by multivariate Logistic regression.Results The results of univariate analysis showed that the age in the group with intraoperative hypothermia was higher than that in the group without intraoperative hypothermia,and the anesthesia time and operation time were longer than those in the group without intraoperative hypothermia,while the amount of fluid replacement,carbon dioxide consumption and bleeding volume were higher than those in the group without intraoperative hypothermia,with statistical significance.Multivariate Logistic analysis showed that anesthesia time≥90 min,operation time≥120 min,fluid infusion≥2000 mL,carbon dioxide dosage≥150 L,and bleeding volume≥100 mL were all risk factors for intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia.Conclusion Risk factors that affected the occurrence of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia included anesthesia time≥90 min,operation time≥120 min,fluid infusion≥2000 mL,carbon dioxide dosage≥150 L,and bleeding volume≥100 mL.Therefore,targeted intervention measures could be taken for patients undergoing laparoscopic hysterectomy under general anesthesia to reduce the risk of intraoperative hypothermia.