老年全麻手术患者术中低体温发生的相关危险因素及其干预措施分析

Analysis of risk factors and intervention measures for intraoperative hypothermia in elderly patients undergoing general anesthesia

目的探讨老年全麻手术患者术中低体温发生的相关危险因素及其干预措施。方法选择2022年1月-2023年12月本院226例进行全麻手术治疗的老年患者为研究对象,根据低体温发生情况将患者分为低体温组(80例)与正常组(146例)两组。对比两组患者相关资料,分析老年患者术中发生低体温的危险因素,并制定干预措施。结果226例老年全麻手术患者中,术中共有80例发生低体温,发生率为35.40%(80/226);单因素分析发现,低体温组患者手术时间≥150 min、年龄≥75岁、术前中重度贫血、麻醉时间≥120 min、未进行术中保暖、CO_(2)灌注量≥200 L、CO_(2)未加温、CO_(2)气腹时间≥120 min、冲洗液量≥1.5 L、出血量≥150 ml、补液量≥1 L占比均高于正常组,差异有统计学意义(P<0.05);两组患者性别、婚姻状态、学历、基础体温、平均动脉压、是否合并基础疾病、入室状态等比较,差异无统计学意义(P>0.05);Logistic回归分析:手术时间≥150 min、年龄≥75岁、术前中重度贫血、麻醉时间≥120 min、术中未进行保暖、CO_(2)灌注量≥200 L、术中CO_(2)未加温、CO_(2)气腹时间≥120 min、补液量≥1 L、冲洗液量≥1.5 L、出血量≥150 ml是老年全麻手术患者术中发生低体温的独立危险因素(P<0.05且OR≥1)。结论受手术时间≥150 min、年龄≥75岁、术前中重度贫血、麻醉时间≥120 min、术中未进行保暖、CO_(2)灌注量≥200 L、术中CO_(2)未加温、CO_(2)气腹时间≥120 min、补液量≥1 L、冲洗液量≥1.5 L、出血量≥150 ml等因素影响,老年全麻手术患者术中低体温发生率较高,临床需予以高度重视,积极制定干预措施,尽可能降低术中低体温发生风险,提高手术安全性。

Objective To Objective:To investigate the risk factors and intervention measures for intraoperative hypothermia in elderly patients undergoing general anesthesia.Methods A total of 226 elderly patients undergoing general anesthesia for surgery at our hospital from January 2022 to December 2023 were enrolled in this study.Patients were divided into a hypothermia group(n=80)and a normal group(n=146)based on the occurrence of hypothermia.The relevant data of the two groups were compared to analyze the risk factors for intraoperative hypothermia in elderly patients and to develop intervention measures.Results Among the 226 elderly patients undergoing general anesthesia,80 cases of hypothermia occurred,with an incidence rate of 35.40%(80/226).Univariate analysis found that in the hypothermia group,the proportion of patients with surgery time≥150 min,age≥75 years,preoperative moderate to severe anemia,anesthesia time≥120 min,no intraoperative warming,CO_(2)insufflation volume≥200 L,CO_(2)not warmed,CO_(2)pneumoperitoneum time≥120 min,irrigation fluid volume≥1.5 L,and blood loss≥150 mL was higher than in the normal group,with statistically significant differences(P<0.05).There were no significant differences between the two groups in terms of gender,marital status,education level,basal body temperature,mean arterial pressure,presence of underlying diseases,or admission status(P>0.05).Logistic regression analysis identified surgery time≥150 min,age≥75 years,preoperative moderate to severe anemia,anesthesia time≥120 min,lack of intraoperative warming,CO_(2)insufflation volume≥200 L,CO_(2)not warmed during surgery,CO_(2)pneumoperitoneum time≥120 min,fluid replacement volume≥1 L,irrigation fluid volume≥1.5 L,and blood loss≥150 mL as independent risk factors for intraoperative hypothermia in elderly patients undergoing general anesthesia(P<0.05 and OR≥1).Conclusions Influenced by factors such as surgery time≥150 min,age≥75 years,preoperative moderate to severe anemia,anesthesia time≥120 min,lack of intraoperative warming,CO_(2)insufflation volume≥200 L,CO_(2)not warmed during surgery,CO_(2)pneumoperitoneum time≥120 min,fluid replacement volume≥1 L,irrigation fluid volume≥1.5 L,and blood loss≥150 mL,the incidence of intraoperative hypothermia in elderly patients undergoing general anesthesia is relatively high.Clinical attention should be paid to this issue,and intervention measures should be actively formulated to reduce the risk of intraoperative hypothermia and improve surgical safety.