儿童腹腔镜术中低体温发生相关因素的调查

Related Factors of Hypothermia in Children during Laparoscopic Operation

目的探讨儿童腹腔镜手术中低体温发生的相关因素及干预措施。方法回顾性收集并分析2016年1-12月徐州市儿童医院收治的行腹腔镜手术的450例患儿的临床资料,所有患儿均于术中测量鼻咽温度,术中发生低体温193例(观察组),未发生低体温257例(对照组),对两组患者的相关资料进行比较,采用Logistic多因素回归分析患儿术中低体温发生的相关因素。结果观察组患儿血栓弹力图(thrombelastogram,TEG)异常、室性心律失常、术后切口感染的发生率均高于对照组患儿(均P<0.05),麻醉后恢复时间(中位数为95.48 min)长于对照组(中位数为42.16 min),差异有统计学意义(P<0.05);Logistic多因素回归分析显示,儿童术中低体温独立危险因素包括麻醉时间、CO2用量。结论儿童腹腔镜术中低体温的发生率较高,增加了围术期风险,其发生与麻醉时间、CO2用量密切相关,需根据相关因素采取针对性的干预措施,以减少术中低体温发生。

Objective To explore the related factors and intervention measures of hypothermia in children during laparoscopic operation.Methods Clinical data of 450 children received laparoscopic operation from January 2016 to December 2016 were analyzed retrospectively.The nasopharyngeal temperature was measured during operation in all children.There were 193 cases with hypothermia（observation group）and 257 cases without hypothermia（control group）during the operation.The related data was compared between the two groups,and the related factors of hypothermia during operation were analyzed by multivariate logistic regression analysis.Results The incidence rates of abnormal thrombelastogram,ventricular arrhythmia and postoperative incision infection in the observation group were significantly higher than those in the control group（all P〈0.05）.The recovery time of the observation group was significantly longer than that of the control group[（95.48±54.36）min vs（42.16±37.28）min]（P〈0.05）.Logistic multivariate regression analysis showed that the independent risk factors of hypothermia during operation included anesthesia time and dosage of CO2.Conclusions The incidence of hypothermia during operation is high in children,which increases perioperative risk.The occurrence of hypothermia is closely related to the duration of anesthesia and the dosage of CO2.The intervention measures should be taken according to the related factors to reduce the occurrence of hypothermia during operation.