外科术中意外低体温危险因素调查研究

Investigation on the risk factors of accidental hypothermia during surgery

目的调查分析外科手术患者术中意外低体温的危险因素。方法选择2019年1月~2020年6月我院进行择期外科手术的患者260例为研究对象,调查患者外科术中意外低体温的发生率,收集患者临床资料,运用单因素和多因素Logistic回归分析探讨患者术中发生意外低体温的危险因素。结果260例患者中有46例发生外科术中意外低体温,发生率为17.69%;单因素分析显示,患者年龄、BMI、术前焦虑、入室体温、手术室温度、麻醉时间、手术时间、手术方式、术中出血量、术中补液量、术中冲洗量及术中保暖方式与发生外科术中意外低体温明显相关(P<0.05);多因素Logistic回归分析显示,患者年龄、BMI、手术方式、手术时间、麻醉时间、术中出血量、术中补液量、术中保暖方式均为发生外科术中意外低体温的独立危险因素。结论高龄、BMI低、术前焦虑、手术和麻醉时间长、术中液体出入量大、术中保暖措施欠缺等均为发生外科术中意外低体温的危险因素,临床中应该引起重视,加强对患者的保温处理,以降低低体温发生风险。

Objective To investigate and analyze the risk factors of accidental hypothermia in surgical patients.Methods A total of 260 patients undergoing elective surgery in our hospital from January 2019 to June 2020 were selected as the study objects.The incidence of accidental hypothermia during the surgery of patients was investigated.The patients'clinical data were collected.Single factor and multivariate Logistic regression were used to analyze the influencing factors of accidental hypothermia during surgery.Results A total of 46 of 260 patients had accidental hypothermia during surgery,with the incidence of 17.69%.Single factor analysis showed that patient age,BMI,preoperative anxiety,entrance temperature,operating room temperature,duration of anesthesia,length of operation,method of operation,intraoperative bleeding,intraoperative fluid rehydration,intraoperative irrigation,and intraoperative warmth were significantly related to accidental hypothermia during operation(P<0.05).Multivariate logistic regression analysis showed that patient age,BMI,operation method,operation time,anesthesia time,intraoperative blood loss,intraoperative fluid rehydration,and intraoperative warmth were all independent influencing factors of accidental hypothermia during surgery.Conclusion Old age,low BMI,preoperative anxiety,long operation and anesthesia time,large volume of fluids during surgery,lack of intraoperative warmth are all important factors affecting the occurrence of accidental hypothermia during surgery.Clinical attention should be paid.The insulation care of patients was strengthened to reduce the risk of hypothermia.