剖宫产术中低体温的影响因素分析及风险预测模型构建

Analysis of influencing factors of hypothermia during cesarean section and construction of risk prediction model

目的分析剖宫产术中低体温的影响因素,并构建相关风险预测模型,以期为降低低体温发生风险提供有力参考。方法回顾性分析我院收治的150例剖宫产产妇的临床资料,根据术中产妇是否发生低体温对其进行分组,比较两组的临床资料;采用二元Logistic回归分析探讨剖宫产术中低体温的影响因素,并根据回归系数得出联合预测数值,采用受试者工作特征(ROC)曲线分析其对剖宫产术中低体温的预测价值。结果150例剖宫产产妇中,34例术中发生低体温,116例未发生低体温。两组的麻醉后体温、采取主动保温、保温措施种类、输液加温、术中室温、术中输血、进入手术室室温、术中冲洗伤口液体量、术中冲洗腹腔液体量、术中液体丢失量比较,差异具有统计学意义(P<0.05)。二元Logistic回归分析显示,输液加温、术中输血、进入手术室室温是剖宫产术中低体温发生的影响因素(P<0.05)。ROC曲线显示,联合预测曲线下面积(AUC)为0.915,灵敏度为94.10%,特异度为76.70%,约登指数为0.708。结论输液加温、术中输血、进入手术室室温是剖宫产术中低体温发生的影响因素,将相关影响因素纳入至风险预测模型中能够准确预测低体温的发生风险,有效预防低体温的发生。

Objective To analyze the influencing factors of hypothermia during cesarean section,and to construct a relevant risk prediction model,in order to provide a strong reference for reducing the risk of hypothermia.Methods The clinical data of 150 parturients undergoing cesarean section admitted in our hospital were retrospectively analyzed.The parturients were divided into two groups according to whether hypothermia occurred during operation,and the clinical data of the two groups were compared.Binary Logistic regression analysis was used to explore the influencing factors of hypothermia during cesarean section,and the combined prediction values were obtained according to the regression coefficient.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of hypothermia during cesarean section.Results Among the 150 cases of parturients with cesarean section,34 cases had hypothermia during operation,and 116 cases had no hypothermia.There were significant differences in body temperature after anesthesia,active heat preservation,types of heat preservation measures,infusion heating,intraoperative room temperature,intraoperative blood transfusion,entering the operating room temperature,intraoperative flushing of wound fluid volume,intraoperative flushing of abdominal fluid volume,and intraoperative fluid loss between the two groups(P<0.05).Binary Logistic regression analysis showed that infusion heating,intraoperative blood transfusion,and entering the operating room temperature were the influencing factors of intraoperative hypothermia in cesarean section(P<0.05).ROC curve showed that the area under curve(AUC)of the combined prediction curve was 0.915,the sensitivity was 94.10%,the specificity was 76.70%,and the Youden index was 0.708.Conclusion Infusion heating,intraoperative blood transfusion,and entering the operating room temperature are the influencing factors of hypothermia during cesarean section.Incorporating relevant influencing factors into the risk prediction model can accurately predict the risk of hypothermia,effectively prevent hypothermia.