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老年患者骨盆底重建手术围手术期低温:一项观察性研究。

Perioperative Hypothermia in Elderly Patients During Pelvic Floor Reconstruction Surgery: An Observational Study.

机构信息

Department of Anesthesiology, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, 310008, China.

Department of Urolithiasis and Anorectal Surgery, Ningbo No. 2 Hospital, 41 Xibei Street, Ningbo, 315010, Zhejiang Province, China.

出版信息

Int Urogynecol J. 2024 Jun;35(6):1163-1170. doi: 10.1007/s00192-024-05781-9. Epub 2024 May 2.

Abstract

INTRODUCTION AND HYPOTHESIS

The potential predictors of pelvic floor reconstruction surgery hypothermia remain unclear. This prospective cohort study was aimed at identifying these predictors and evaluating the outcomes associated with perioperative hypothermia.

METHODS

Elderly patients undergoing pelvic floor reconstruction surgery were consecutively enrolled from April 2023 to September 2023. Perioperative temperature was measured at preoperative (T1), every 15 min after the start of anesthesia (T2), and 15 min postoperative (T3) using a temperature probe. Perioperative hypothermia was defined as a core temperature below 36°C at any point during the procedure. Multivariate logistic regression analysis was conducted to determine factors associated with perioperative hypothermia.

RESULTS

A total of 229 patients were included in the study, with 50.7% experiencing hypothermia. Multivariate analysis revealed that the surgical method involving pelvic floor combined with laparoscopy, preoperative temperature < 36.5°C, anesthesia duration ≥ 120 min, and the high levels of anxiety were significantly associated with perioperative hypothermia. The predictive value of the multivariate model was 0.767 (95% CI, 0.706 to 0.828).

CONCLUSIONS

This observational prospective study identified several predictive factors for perioperative hypothermia in elderly patients during pelvic floor reconstruction surgery. Strategies aimed at preventing perioperative hypothermia should target these factors. Further studies are required to assess the effectiveness of these strategies, specifically in elderly patients undergoing pelvic floor reconstruction surgery.

摘要

介绍和假设

盆腔重建手术低温的潜在预测因素仍不清楚。本前瞻性队列研究旨在确定这些预测因素,并评估与围手术期低温相关的结果。

方法

2023 年 4 月至 2023 年 9 月,连续纳入行盆腔重建手术的老年患者。使用温度探头在术前(T1)、麻醉开始后每 15 分钟(T2)和术后 15 分钟(T3)测量围手术期温度。术中任何时候核心温度低于 36°C 定义为围手术期低温。采用多变量逻辑回归分析确定与围手术期低温相关的因素。

结果

共纳入 229 例患者,其中 50.7%发生低温。多变量分析显示,涉及盆腔联合腹腔镜的手术方法、术前体温<36.5°C、麻醉时间≥120 分钟和高度焦虑与围手术期低温显著相关。多变量模型的预测值为 0.767(95%置信区间,0.706 至 0.828)。

结论

本观察性前瞻性研究确定了老年患者行盆腔重建手术期间围手术期低温的几个预测因素。旨在预防围手术期低温的策略应针对这些因素。需要进一步研究评估这些策略在接受盆腔重建手术的老年患者中的有效性。

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