择期手术患儿发热原因分析及应对措施

Analysis on the causes of fever in children under elective surgery and its countermeasures

目的探讨分析择期手术患儿发热的原因及应对措施。方法选择2014年1月~2016年7月入住解放军总医院小儿外科的待手术患儿200例,将其随机分成实验组和对照组,各100例。对照组行常规术前准备,实验组患儿除行常规术前准备外还要进行术前补液。分析两组患儿性别、疾病种类、月龄、身高、体重五方面的数据,并对两组患儿术前平均体温、平均住院天数及发热情况进行统计学分析。结果两组患儿性别、疾病种类、月龄、身高、体重比较,差异无统计学意义(P>0.05)。两组术前平均体温和平均住院天数比较差异有统计学意义(P<0.05)。对照组出现10例(10%)发热病例,实验组出现1例(1%)发热病例,实验组发热率明显低于对照组,差异有统计学意义(χ~2=7.792,P<0.05),同时发现实验组1例发热患儿月龄为8个月,对照组10例发热患儿中0~12月龄的占4例,>12~48月龄的占3例,>48~84月龄的占2例,>84~168月龄的占1例,说明年龄越小越容易出现发热。结论术前静脉补液对于预防择期手术患儿出现发热有重要的临床意义。

Objective To investigate and analyze the causes of fever in children under elective surgery and its countermeasures. Methods Two hundred children underwent elective surgery in Department of Pediatric Surgery of Chinese PLA General Hospital from January 2014 to July 2016 were selected and randomly divided into the experimental group and the control group, with 100 patients in each group. The control group received routine preoperative preparation. In addition to routine preoperative preparation, the experimental group was given preoperative fluid replacement. The gender, categories of disease, age, height and weight were analyzed between the two groups, and the results of average body temperature, average hospitalization time and fever conditions of the two groups were analyzed with statistics. Resuits There were no significant differences of the gender, categories of disease, age, height and weight between the two groups （P 〉 0.05）. There were significant differences of average body temperature and average hospitalization time between the two groups （P 〈 0.05）. There were 10 cases （10%） of fever in the control group and 1 case （1%） of fever in the experimental group, the incidence of fever in the experimental group was significantly lower than that of the control group （X2=7.792, P 〈 0.05）. At the same time, one case of fever in the experimental group was 8 months old. Among the 10 febrile children of control group, 4 cases of them were in the 0-12 months, 3 cases were in the 〉12-48 months range, 2 cases were in the 〉48-84 months range and 1 case was in the 〉84-168 months range, which showed that the younger were more prone to fever. Conclusion Preoperative intravenous fluid replacement for the prevention of elective surgery in children with fever has important clinical significance.