摘要
目的分析腰椎单侧双通道脊柱内镜(Unilateral biportal endoscopy,UBE)术中发生低体温的危险因素,并构建列线图预测模型。方法回顾性分析自2024-01—2025-01采用UBE手术治疗的216例腰椎退行性疾病,以术中是否出现低体温(监测体温降至36℃以下)作为划分依据,分为低体温组和正常体温组。收集患者基础资料、手术相关资料,进行单因素分析和多因素Logistic回归分析腰椎UBE术中低体温发生的独立危险因素,进而构建列线图预测模型。结果216例中有48例术中出现低体温,发生率为22.2%。低体温组48例,正常体温组168例,单因素分析结果显示,性别、吸烟、高血压、冠状动脉粥样硬化性心脏病、慢性阻塞性肺疾病、术前血红蛋白水平、术前白蛋白水平、进入手术室体温、手术侧别、术中输液量、术中出血量与UBE术中低体温发生无关(P>0.05),而年龄、体质量指数、合并糖尿病、ASA分级、手术时间、术中冲洗量与UBE术中低体温发生相关(P<0.05)。多因素Logistic回归分析结果显示高龄、体质量指数低、手术时间延长、术中冲洗量大是腰椎UBE术中低体温的独立危险因素(P<0.05)。然后建立UBE术中发生低体温的列线图预测模型,ROC曲线下AUC值为0.958,证实建立的列线图模型可以较好地预测腰椎UBE术中低体温的风险。结论高龄、体质量指数低、手术时间长、术中冲洗量大是腰椎UBE术中出现低体温的独立危险因素,并且成功构建了列线图预测模型。临床医师应密切观察上述影响因素,采用有效的预防方法降低UBE术中低体温的发生率。
Objective To analyze the risk factors for intraoperative hypothermia during lumbar unilateral biportal endoscopy(UBE)and establish a predictive nomogram model.Methods A retrospective analysis was performed on 216 patients with lumbar degenerative diseases who underwent UBE from January 2024 to January 2025.Patients were divided into a hypothermia group(body temperature<36℃)and a normothermia group according to the occurrence of intraoperative hypothermia.Baseline and surgery-related data were collected.Univariate analysis and multivariate Logistic regression were used to identify independent risk factors for intraoperative hypothermia during lumbar UBE,and a predictive nomogram was subsequently constructed.Results Intraoperative hypothermia occurred in 48 of 216 patients,with an incidence rate of 22.2%.There were 48 patients in the hypothermia group and 168 in the normothermia group.Univariate analysis showed that gender,smoking,hypertension,coronary atherosclerotic heart disease,chronic obstructive pulmonary disease,preoperative hemoglobin,preoperative albumin,body temperature at admission to operation room,surgical side,intraoperative infusion volume,and intraoperative blood loss were not associated with intraoperative hypothermia(P>0.05),whereas age,body mass index(BMI),diabetes mellitus,ASA classification,operation time,and intraoperative irrigation volume were significantly correlated(P<0.05).Multivariate Logistic regression revealed that advanced age,low BMI,prolonged operation time,and large intraoperative irrigation volume were independent risk factors for intraoperative hypothermia during lumbar UBE(P<0.05).The nomogram model was established,and the area under the ROC curve(AUC)was 0.958,indicating good predictive performance for intraoperative hypothermia during lumbar UBE.Conclusion Advanced age,low BMI,long operation time,and large intraoperative irrigation volume are independent risk factors for intraoperative hypothermia during lumbar UBE.A predictive nomogram model was successfully constructed.Clinicians should closely monitor these factors and adopt effective preventive measures to reduce the incidence of intraoperative hypothermia in UBE.
作者
陈晓敏
王兢
付丹丹
费琦
孟海
CHEN Xiaomin;WANG Jing;FU Dandan;FEI Qi;MENG Hai(Department of Anesthesia and Surgery Center,Beijing Friendship Hospital Capital Medical University,Beijing 100050,China;不详)
出处
《中国骨与关节损伤杂志》
2026年第3期252-256,共5页
Chinese Journal of Bone and Joint Injury
关键词
腰椎退行性疾病
单侧双通道脊柱内镜
术中低体温
列线图
危险因素
Lumbar degenerative diseases
Unilateral biportal endoscopy
Intraoperative hypothermia
Nomogram
Risk factor
