摘要
目的 探讨腹腔镜下子宫肌瘤切除手术过程中导致患者体温降低的关键风险因素,为临床预防和干预提供依据。方法 选择2023-07-01-2024-08-30淄博市妇幼保健院收治的40例腹腔镜下子宫肌瘤切除术中发生低体温的患者作为病例组,另外选择40例同期接受腹腔镜下子宫肌瘤切除术中体温正常者作为对照组。对所有入组手术患者的体温进行监测,通过单因素和多因素logistic回归分析,明确影响子宫肌瘤腹腔镜切除术中低体温发生的独立及相关危险因素。结果 单因素分析结果显示,主动保温(χ^(2)=7.813,P=0.005)、身体质量指数(BMI,χ^(2)=22.969,P<0.001)、环境温度(χ^(2)=33.991,P<0.001)、年龄(χ^(2)=24.444,P<0.001)、术中失血量(χ^(2)=22.604,P<0.001)以及术中输液量(χ^(2)=18.061,P<0.001)为影响子宫肌瘤腹腔镜切除术中低体温发生的相关危险因素。多因素分析结果显示,术中未主动采取保温措施(OR=2.792,95%CI为1.417~5.502,P=0.003)、BMI≤18.5 kg/m^(2)(OR=1.016,95%CI为1.001~1.032,P=0.038)、年龄>60岁(OR=2.673,95%CI为1.202~5.942,P=0.016)、术中失血量>800 mL(OR=1.923,95%CI为1.284~2.880,P=0.002)及术中输液量>2 000 mL(OR=2.059,95%CI为1.244~3.407,P=0.005)为低体温发生的独立危险因素。结论 针对子宫肌瘤腹腔镜切除术者,尤其是BMI<18.5 kg/m^(2)、年龄>60岁、术中失血量>800 mL以及术中输液量>2 000 mL者,实施术中主动保温,对减少术中低体温发生有积极意义。
Objective To explore the key risk factors leading to hypothermia during laparoscopic myomectomy and provide a basis for clinical prevention and intervention.Methods A total of 40patients who experienced hypothermia during laparoscopic myomectomy at Zibo Maternal and Child Health Hospital from July 1,2023to August 30,2024were selected as the case group,and 40patients with normal body temperature during the same period were selected as the control group.Body temperature was monitored for all enrolled surgical patients.Univariate and multivariate logistic regression analyses were performed to identify independent and related risk factors for hypothermia during laparoscopic myomectomy.Results Univariate analysis showed that active warming(χ^(2)=7.813,P=0.005),body mass index(BMI,χ^(2)=22.969,P<0.001),ambient temperature(χ^(2)=33.991,P<0.001),age(χ^(2)=24.444,P<0.001),intraoperative blood loss(χ^(2)=22.604,P<0.001),and intraoperative fluid volume(χ^(2)=18.061,P<0.001)were related risk factors for hypothermia during laparoscopic myomectomy.Multivariate analysis revealed that failure to actively take warming measures(OR=2.792,95%CI:1.417-5.502,P=0.003),BMI≤18.5kg/m^(2)(OR=1.016,95%CI:1.001-1.032,P=0.038),age>60years(OR=2.673,95%CI:1.202-5.942,P=0.016),intraoperative blood loss>800ml(OR=1.923,95%CI:1.284-2.880,P=0.002),and intraoperative fluid volume>2000ml(OR=2.059,95%CI:1.244-3.407,P=0.005)were independent risk factors for hypothermia.Conclusion For patients undergoing laparoscopic myomectomy,especially those with BMI<18.5kg/m^(2),age>60years,intraoperative blood loss>800ml,and intraoperative fluid volume>2000ml,implementing active intraoperative warming is of positive significance in reducing the occurrence of intraoperative hypothermia.
作者
王艳丽
刘亚男
赵静
WANG Yanli;LIU Ya'nan;ZHAO Jing(Department of Anesthesiology,Zibo Maternal and Child Health Hospital,Zibo,Shandong 255000,China)
出处
《社区医学杂志》
2025年第5期177-180,共4页
Journal Of Community Medicine
