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口腔颌面外科手术中意外术中低体温的发生率及其危险因素:一项前瞻性研究。

Incidence of Unintentional Intraoperative Hypothermia and Its Risk Factors in Oral and Maxillofacial Surgery: A Prospective Study.

机构信息

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, PR China; Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, PR China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.

出版信息

J Perianesth Nurs. 2023 Dec;38(6):876-880. doi: 10.1016/j.jopan.2023.01.019. Epub 2023 Aug 10.

Abstract

PURPOSE

Unintentional intraoperative hypothermia is a common complication in patients who undergo open surgery, increasing the risk of adverse outcomes. However, few studies have focused on intraoperative hypothermia during oral and maxillofacial surgery. Our study aimed to analyze the prevalence and risk factors of hypothermia in patients who underwent oral and maxillofacial surgery.

DESIGN

A prospective cohort study was conducted on 128 patients who underwent oral and maxillofacial surgery.

METHODS

This prospective study was conducted at West China Hospital of Stomatology between December 2020 and May 2021, and each patient was followed for at least 1-month postoperatively. Patients who underwent oral and maxillofacial surgery under general anesthesia, with at least 1-month follow-up were analyzed. The primary variable was intraoperative hypothermia, defined as core body temperature less than 36°C, measured using a tympanic thermometer during the surgery. We performed univariate and multivariate logistic regression analyses to identify the risk factors of unintentional intraoperative hypothermia.

FINDINGS

The mean age of the 128 patients was 31.0 ± 20.9 years, and there was a male predominance (53.1%), with male to female ratio of 1.13:1. Thirty-one patients (24.2%) developed hypothermia intraoperatively. Older age (OR = 1.068, 95% CI: 1.028-1.110, P = .001), lower weight (OR = 0.878, 95% CI: 0.807-0.955, P = .002), greater blood loss (OR = 1.003, 95% CI: 1.000-1.006, P = .034), and undergoing cancer surgery (OR = 0.210, 95% CI: 0.067-0.656, P = .007) were associated with intraoperative hypothermia.

CONCLUSIONS

Unintentional intraoperative hypothermia is common in patients who undergo surgery for oral cancer. Warming interventions to prevent intraoperative hypothermia for high-risk patients (older, lower weight, or more intraoperative bleeding) should be considered. Meanwhile, with careful nursing and rehabilitation instructions, intraoperative hypothermia does not lead to serious perioperative complications.

摘要

目的

在接受开放性手术的患者中,术中意外低体温是一种常见的并发症,增加了不良结局的风险。然而,很少有研究关注口腔颌面外科手术中的术中低体温。我们的研究旨在分析口腔颌面外科手术患者中低体温的发生率和危险因素。

设计

对 128 例接受口腔颌面外科手术的患者进行前瞻性队列研究。

方法

本前瞻性研究于 2020 年 12 月至 2021 年 5 月在华西口腔医院进行,每位患者术后至少随访 1 个月。分析接受全身麻醉下口腔颌面外科手术、至少随访 1 个月的患者。主要变量是术中低体温,定义为术中使用鼓膜温度计测量时核心体温<36°C。我们进行了单因素和多因素 logistic 回归分析,以确定术中意外低体温的危险因素。

发现

128 例患者的平均年龄为 31.0±20.9 岁,男性居多(53.1%),男女比例为 1.13:1。31 例(24.2%)患者术中发生低体温。年龄较大(OR=1.068,95%CI:1.028-1.110,P=0.001)、体重较低(OR=0.878,95%CI:0.807-0.955,P=0.002)、出血量较大(OR=1.003,95%CI:1.000-1.006,P=0.034)和接受癌症手术(OR=0.210,95%CI:0.067-0.656,P=0.007)与术中低体温有关。

结论

口腔癌手术患者术中意外低体温较为常见。对于高危患者(年龄较大、体重较低或术中出血较多),应考虑采用加温干预措施预防术中低体温。同时,通过精心护理和康复指导,术中低体温不会导致严重的围手术期并发症。

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