Aim: The relationship between preoperative anxiety level and intraoperative hypothermia (<36℃) was investigated. Background: Core temperature often decreases during surgery, with an initial rapid decrease followed...Aim: The relationship between preoperative anxiety level and intraoperative hypothermia (<36℃) was investigated. Background: Core temperature often decreases during surgery, with an initial rapid decrease followed by a slower decrease for about 2 hours. Preoperative anxiety may influence perioperative physiological responses. The relationship between preoperative anxiety level and perioperative decrease in core temperature has not been studied closely. Design: A prospective observational study. Methods: This study enrolled 120 adult patients who underwent elective major abdominal surgery under combined epidural and general anesthesia. Tympanic membrane temperature was used to measure core temperature preoperatively and during the operation. The relationship between anxiety level according to the State-Trait Anxiety Inventory (STAI) and core temperature was examined using descriptive and multivariate risk analysis. Results: High anxiety level was found in 61 patients (51%), of which 26 (43%) developed hypothermia during the first hour and 40 (66%) developed hypothermia during the first 2 hours of anesthesia. After adjustment for covariates, patients with a high anxiety level were found to have a 2.17-fold higher risk of hypothermia during the first hour and a 1.77-fold higher risk of hypothermia during the first 2 hours than patients with a low/moderate anxiety level. Conclusions: The risk of hypothermia in the early phase of general anesthesia can be predicted by measurement of the preoperative anxiety level using the STAI. Relevance to Clinical Practice: Patients with a high anxiety level had a significantly higher risk of intraoperative hypothermia. Preoperative preventive nursing care programs should include anxiety management and thermal care.展开更多
目的通过Meta分析明确急诊创伤患者发生低体温的影响因素。方法计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase、Cochrane Library等数据库中关于急诊创伤患者低体温影响因素的...目的通过Meta分析明确急诊创伤患者发生低体温的影响因素。方法计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase、Cochrane Library等数据库中关于急诊创伤患者低体温影响因素的队列研究和病例对照研究,检索时限为建库至2023年7月,由两名研究者独立进行文献筛选、数据提取、质量评价后,采用RevMan 5.4.1软件进行Meta分析。结果共纳入10篇文献,包括8个影响因素:收缩压(OR=0.99)、修正创伤评分(Revised Trauma Score,RTS)(OR=0.60)、创伤严重程度评分(Injury Severe Score,ISS)(OR=1.02)、救护车到达时患者卧于地面(OR=8.22)、气温(OR=0.95)、冬季(OR=2.20)、转运过程中采取保暖措施(OR=0.25)和院前插管(OR=6.41)。结论收缩压、RTS、ISS、救护车到达时患者卧于地面、气温、冬季、转运过程中采取保暖措施和院前插管是急诊创伤患者发生低体温的影响因素。提示护理人员可依据影响因素,针对性地采取预防措施,降低急诊创伤患者低体温发生率,从而减少创伤患者死亡风险。展开更多
目的构建预测后路腰椎椎间融合患者术中低体温发生风险的决策树模型。方法2022年6-9月,采用便利抽样法选取于某医院行后路腰椎椎间融合术的102例患者为研究对象,根据是否发生术中低体温将其分为低体温组(n=77)和非低体温组(n=25),使用...目的构建预测后路腰椎椎间融合患者术中低体温发生风险的决策树模型。方法2022年6-9月,采用便利抽样法选取于某医院行后路腰椎椎间融合术的102例患者为研究对象,根据是否发生术中低体温将其分为低体温组(n=77)和非低体温组(n=25),使用单因素和多因素Logistic回归分析发生术中低体温的危险因素,并建立相关决策树预测模型。结果体质量指数(body mass index,BMI)较低、美国麻醉医生协会(American Society of Aneshesiologists,ASA)评分较高、入室体温较低、手术时间较长和出血量较多是后路腰椎椎间融合术患者术中低体温的独立危险因素(均P<0.05);基于上述因素建立了预测后路腰椎椎间融合术患者术中低体温发生风险的决策树模型,模型验证结果显示,曲线下面积(area under curve,AUC)为0.821(95%CI:0.798~0.844)。结论基于影响因素构建的决策树模型,对后路腰椎椎间融合术患者术中低体温的发生风险具有良好的预测能力。展开更多
文摘Aim: The relationship between preoperative anxiety level and intraoperative hypothermia (<36℃) was investigated. Background: Core temperature often decreases during surgery, with an initial rapid decrease followed by a slower decrease for about 2 hours. Preoperative anxiety may influence perioperative physiological responses. The relationship between preoperative anxiety level and perioperative decrease in core temperature has not been studied closely. Design: A prospective observational study. Methods: This study enrolled 120 adult patients who underwent elective major abdominal surgery under combined epidural and general anesthesia. Tympanic membrane temperature was used to measure core temperature preoperatively and during the operation. The relationship between anxiety level according to the State-Trait Anxiety Inventory (STAI) and core temperature was examined using descriptive and multivariate risk analysis. Results: High anxiety level was found in 61 patients (51%), of which 26 (43%) developed hypothermia during the first hour and 40 (66%) developed hypothermia during the first 2 hours of anesthesia. After adjustment for covariates, patients with a high anxiety level were found to have a 2.17-fold higher risk of hypothermia during the first hour and a 1.77-fold higher risk of hypothermia during the first 2 hours than patients with a low/moderate anxiety level. Conclusions: The risk of hypothermia in the early phase of general anesthesia can be predicted by measurement of the preoperative anxiety level using the STAI. Relevance to Clinical Practice: Patients with a high anxiety level had a significantly higher risk of intraoperative hypothermia. Preoperative preventive nursing care programs should include anxiety management and thermal care.
文摘目的通过Meta分析明确急诊创伤患者发生低体温的影响因素。方法计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase、Cochrane Library等数据库中关于急诊创伤患者低体温影响因素的队列研究和病例对照研究,检索时限为建库至2023年7月,由两名研究者独立进行文献筛选、数据提取、质量评价后,采用RevMan 5.4.1软件进行Meta分析。结果共纳入10篇文献,包括8个影响因素:收缩压(OR=0.99)、修正创伤评分(Revised Trauma Score,RTS)(OR=0.60)、创伤严重程度评分(Injury Severe Score,ISS)(OR=1.02)、救护车到达时患者卧于地面(OR=8.22)、气温(OR=0.95)、冬季(OR=2.20)、转运过程中采取保暖措施(OR=0.25)和院前插管(OR=6.41)。结论收缩压、RTS、ISS、救护车到达时患者卧于地面、气温、冬季、转运过程中采取保暖措施和院前插管是急诊创伤患者发生低体温的影响因素。提示护理人员可依据影响因素,针对性地采取预防措施,降低急诊创伤患者低体温发生率,从而减少创伤患者死亡风险。
文摘目的构建预测后路腰椎椎间融合患者术中低体温发生风险的决策树模型。方法2022年6-9月,采用便利抽样法选取于某医院行后路腰椎椎间融合术的102例患者为研究对象,根据是否发生术中低体温将其分为低体温组(n=77)和非低体温组(n=25),使用单因素和多因素Logistic回归分析发生术中低体温的危险因素,并建立相关决策树预测模型。结果体质量指数(body mass index,BMI)较低、美国麻醉医生协会(American Society of Aneshesiologists,ASA)评分较高、入室体温较低、手术时间较长和出血量较多是后路腰椎椎间融合术患者术中低体温的独立危险因素(均P<0.05);基于上述因素建立了预测后路腰椎椎间融合术患者术中低体温发生风险的决策树模型,模型验证结果显示,曲线下面积(area under curve,AUC)为0.821(95%CI:0.798~0.844)。结论基于影响因素构建的决策树模型,对后路腰椎椎间融合术患者术中低体温的发生风险具有良好的预测能力。
