经尿道前列腺铥激光切除术患者围术期低体温危险因素分析

Analysis of the risk factors of perioperative hypothermia in patients undergoing transurethral thulium laser prostatectomy

目的分析经尿道前列腺铥激光切除术患者在围术期出现体温过低情况的危险因素。方法前瞻性纳入2020年9月—2021年5月在上海市第一人民医院进行经尿道前列腺铥激光切除术患者170例,根据患者是否出现围术期低体温分为正常体温组(n=143)和低体温组(n=27),分析患者术前及围术期临床资料,对患者发生围术期低体温情况进行危险因素评估。结果单因素分析显示:低体温组患者与正常体温组患者在麻醉时间、手术时间、前列腺大小和灌注液总量上的差异具有统计学意义(P<0.05)。logistic回归分析显示:前列腺大小是出现围术期低体温的独立危险因素(P<0.05);进一步将患者按照前列腺大小分组,对于前列腺<80 g的患者前列腺大小是出现围术期低体温的独立危险因素(P<0.05);对于前列腺≥80 g的患者,灌注液总量是出现围术期低体温的独立危险因素(P<0.05)。结论前列腺增生患者在经尿道前列腺铥激光切除术围术期出现低体温现象与前列腺大小、麻醉时间、手术时间、灌注液总量有一定的关联性,在术前应做完善的危险因素评估,并积极采取有效的综合保温措施。

Objective To explore the causes of hypothermia in patients undergoing transurethral thulium laser prostatectomy.Methods A total of 170 patients who underwent transurethral thulium laser prostatectomy in our hospital during Sep.2020 and May 2021 were prospectively enrolled in the study.The patients were divided into normal body temperature group(n=143)and hypothermia group(n=27),based on whether perioperative hypothermia happened.The clinical data were analyzed to evaluate the risk factors of hypothermia.Results Univariate analysis showed that there were statistical differences in anesthesia time,operation time,prostate size and total amount of perfusion fluid between the two groups(P<0.05).Logistic analysis showed that the size of prostate was the independent risk factor of perioperative hypothermia(P<0.05).Patients were further divided according to prostate size.For patients with prostate<80 g,the size of prostate was the independent risk factor of perioperative hypothermia(P<0.05),while for patients with prostate≥80 g,the amount of perfusion fluid was the independent risk factor(P<0.05).Conclusion Perioperative hypothermia in patients undergoing transurethral thulium laser prostatectomy is related to the anesthesia time,operation time,prostate size and total amount of perfusion fluid.It is necessary to evaluate the risk factors before operation and take effective thermal insulation measures.