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腹部手术中体温的预测因素是什么?

What is the predictor of the intraoperative body temperature in abdominal surgery?

机构信息

Operating Rooms, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

J Anesth. 2019 Feb;33(1):67-73. doi: 10.1007/s00540-018-2585-6. Epub 2018 Nov 29.

Abstract

PURPOSE

Inadvertent hypothermia is a relatively common intraoperative complication. Few studies have investigated predictors of body temperature change or the effect of the blanket type used with a forced-air warming device during the intraoperative period. We investigated the predictive factors of intraoperative body temperature change in scheduled abdominal surgery.

METHODS

We retrospectively reviewed the data from 2574 consecutive adult patients who underwent scheduled abdominal surgery in the supine position. Temperature data were collected from anesthesia records. Multiple regression analysis was performed at 60, 120, and 180 min after the surgical incision to identify the factors influencing body temperature change. We conducted nonlinear regression analysis using the equation ΔT = α (e-1) + βt, where ΔT represented the change in intraoperative core temperature (°C), t represented the surgical duration (minutes), and α, β, and γ were constants.

RESULTS

The intraoperative core temperature change was explained by the equation ΔT = 0.59 (e - 1) + 0.0043t. Younger age, higher body mass index (BMI), male sex, laparoscopic surgery, and use of an underbody blanket were associated with increased core temperature at 1 or 2 h after surgical incision. Male sex and an underbody blanket remained strong predictive variables even 3 h after surgical incision, whereas BMI had little explanatory power at this timepoint. The difference in the heating effect of an underbody versus an overbody blanket was 0.0012 °C per minute.

CONCLUSIONS

The blanket type of the forced-air warmer, age, sex, laparoscopic surgery, and BMI are predictors of intraoperative core temperature change.

摘要

目的

意外低体温是一种相对常见的术中并发症。很少有研究调查体温变化的预测因素,也很少有研究调查术中使用强制空气加热设备时毯子类型对体温的影响。我们研究了择期腹部手术中术中体温变化的预测因素。

方法

我们回顾性分析了 2574 例连续接受仰卧位择期腹部手术的成年患者的数据。从麻醉记录中收集体温数据。在手术切口后 60、120 和 180 分钟进行多元回归分析,以确定影响体温变化的因素。我们使用方程 ΔT = α (e-1) + βt 进行非线性回归分析,其中 ΔT 代表术中核心体温变化(°C),t 代表手术持续时间(分钟),α、β和γ是常数。

结果

术中核心体温变化由方程 ΔT = 0.59 (e-1) + 0.0043t 解释。年龄较小、体重指数(BMI)较高、男性、腹腔镜手术和使用下半身毯子与手术切口后 1 或 2 小时核心体温升高有关。即使在手术切口后 3 小时,男性和下半身毯子仍然是强有力的预测变量,而 BMI 此时的解释能力较弱。下半身毯子和上半身毯子的加热效果差异为每分钟 0.0012°C。

结论

强制空气加热设备的毯子类型、年龄、性别、腹腔镜手术和 BMI 是术中核心体温变化的预测因素。

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