Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Int J Womens Health. 2014 Apr 8;6:385-8. doi: 10.2147/IJWH.S57521. eCollection 2014.
The purpose of this study was to assess the incidence of and risk factors for postoperative febrile morbidity after laparoscopic-assisted vaginal hysterectomy (LAVH).
This retrospective study was carried out using the medical records of women with benign gynecologic conditions who underwent LAVH between June 2007 and May 2012 at Srinagarind Hospital in Thailand. Data were collected to assess baseline patient characteristics, occurrence of body temperature ≥38°C on two occasions at least 6 hours apart in the 24 hours following the surgical procedure, and possible risk factors related to postoperative febrile morbidity.
In total, 199 women underwent LAVH during the study period. They had a mean age of 46±6 years, a mean body mass index of 24.0±3.2 kg/m(2), a mean surgical duration of 134±52 minutes, median estimated blood loss of 200 mL, a mean total hospital stay of 5±2 days, and a mean postoperative hospital stay of 3±2 days. Postoperative febrile morbidity was documented in 31 cases (15.6%). The cause of postoperative fever was unknown in most cases, with only two cases having an identifiable cause. The risk of postoperative febrile morbidity was highest in women treated with more than two antibacterial agents and with a regimen of more than 3 days.
This study shows a moderately high rate of febrile morbidity after LAVH, for which the main risk factors were use of multiple drugs and doses for antibiotic prophylaxis.
本研究旨在评估腹腔镜辅助阴道子宫切除术(LAVH)后发热发病率和发热相关因素。
本回顾性研究使用了 2007 年 6 月至 2012 年 5 月期间在泰国诗里叻医院因良性妇科疾病行 LAVH 的女性患者的病历资料。收集数据以评估基线患者特征、术后 24 小时内两次至少相隔 6 小时体温≥38°C 以及与术后发热相关的可能危险因素。
共有 199 名女性在研究期间接受了 LAVH。她们的平均年龄为 46±6 岁,平均体重指数为 24.0±3.2kg/m2,平均手术时间为 134±52 分钟,中位数估计失血量为 200mL,平均总住院时间为 5±2 天,平均术后住院时间为 3±2 天。31 例(15.6%)出现术后发热。大多数情况下术后发热的原因不明,仅有两例有明确病因。使用超过两种抗菌药物和超过 3 天疗程的女性术后发热风险最高。
本研究表明 LAVH 后发热发病率较高,主要危险因素为抗生素预防应用中使用多种药物和剂量。