PACU妇科全麻手术患者非计划性低体温影响因素调查

Investigation on influencing factors of unplanned hypothermia in PACU patients undergoing gynecological general anesthesia

目的调查分析妇科手术患者术后麻醉复苏室(PACU)非计划性低体温的发生状况及相关因素分析。方法选择2019年3—5月术后入住PACU的210例择期全麻妇科手术患者为研究对象,使用基于物联网与AI的无线体温监测系统对本组PACU患者进行连续动态的实时核心体温监测,观察患者术后在PACU期间核心体温的动态变化、非计划性低体温发生率、低体温发生时长占比,并采取单因素分析及二元Logistic多因素回归分析。结果妇科手术患者术后PACU非计划性低体温发生率为37%,在PACU复苏期低体温发生时长占比为0.8。单因素及多因素分析结果显示,年龄≥45岁,非腔镜手术,麻醉诱导时核心体温<36.5℃是妇科手术患者术后PACU低体温的危险因素(P<0.05)。结论全麻妇科患者术后PACU非计划性低体温发生率和低体温发生时长占比均较高,并与患者高年龄、手术类型、手术麻醉前是否进行预保温密切相关。因此提示加强患者术中和进入PACU的持续性核心体温监测,有助于及时了解患者体温变化及时采取干预措施。

Objective To investigate and analyze the occurrence of unplanned hypothermia and related factors in postanesthesia car unit(PACU)after gynecological surgery was set as the study subjects.Methods A total of 210 patients undergoing elective general anesthesia for gynecological surgery who were admitted to PACU from March to May 2019 were selected as the study objects.A wireless body temperature monitoring system based on the Internet of Things and AI was used to perform continuous dynamic real-time core body temperature monitoring for the PACU patients of this group.The dynamic changes of core body temperature,the incidence of unplanned hypothermia,and the proportion of the duration of hypothermia during the postoperative period in PACU were observed,and univariate analysis and binary Logistic multivariate regression analysis was adopted to analyze.Results Incidence of unplanned hypothermia in PACU after gynecological surgery was 37%,and the proportion of the duration of hypothermia during PACU resuscitation was 0.8.Univariate and multivariate analysis showed that the age≥45 years old,in non-laparoscopic surgery,core body temperature<36.5℃during induction of anesthesia was the risk factor for postoperative PACU hypothermia in patients undergoing gynecological surgery(P<0.05).Conclusion The incidence of unplanned hypothermia in PACU and the duration of hypothermia after general anesthesia in gynecological patients were relatively high,and they were closely related to the patient’s age,type of surgery,and whether pre-warming was performed before surgical anesthesia.Therefore,it was suggested to strengthen the continuous core body temperature monitoring of patients during operation and entering PACU,which will help to understand the patient’s temperature changes in time and take intervention measures in time.