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Risk factors and intervention measures of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia |
FANG Min, YAN Lijie, ZHANG Qian, LI Zhenyu |
Department of Anesthesiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029, China |
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Abstract Objective To analyze the risk factors and intervention measures of hypothermia during laparoscopic hysterectomy under general anesthesia. Methods A total of 408 patients who underwent laparoscopic hysterectomy under general anesthesia in the First Affiliated Hospital of Nanjing Medical University from January 2022 to January 2023 were retrospectively included. According to whether there was hypothermia during the operation,they were divided into two groups:51 patients of the group with intraoperative hypothermia and 357 patients of the group without intraoperative hypothermia. The general data of patients were counted,and the single factor analysis of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia was carried out. The related factors affecting the occurrence of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia were analyzed by multivariate Logistic regression. Results The results of univariate analysis showed that the age in the group with intraoperative hypothermia was higher than that in the group without intraoperative hypothermia,and the anesthesia time and operation time were longer than those in the group without intraoperative hypothermia,while the amount of fluid replacement,carbon dioxide consumption and bleeding volume were higher than those in the group without intraoperative hypothermia,with statistical significance. Multivariate Logistic analysis showed that anesthesia time ≥90 min,operation time ≥120 min,fluid infusion ≥2 000 mL,carbon dioxide dosage ≥150 L,and bleeding volume ≥100 mL were all risk factors for intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia. Conclusion Risk factors that affected the occurrence of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia included anesthesia time ≥90 min,operation time ≥120 min,fluid infusion≥2 000 mL,carbon dioxide dosage≥150 L,and bleeding volume≥100 mL. Therefore,targeted intervention measures could be taken for patients undergoing laparoscopic hysterectomy under general anesthesia to reduce the risk of intraoperative hypothermia.
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Received: 18 August 2023
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[1] Okamura A,Isono W,Tsuchiya A,et al.Preventive effect of metronidazole vaginal tablets on vaginal bacteria-related postoperative complications with total laparoscopic hysterectomy[J]. J Med Case Rep,2023,17(1):47. [2] 王红艳,王稳莹,刘燕,等. 腹腔镜子宫切除术对患者ACE、PRC及血流变的影响[J]. 贵州医药,2023,47(1):44-45. [3] He M,Chen M,Yu F.Comparison of total intravenous anesthesia and inhalation anesthesia on postoperative quality of recovery after laparoscopic hysterectomy:a protocol for systematic review and meta-analysis[J]. Medicine,2022,101(51):e32365. [4] 袁琴,陈家驹,杨洁. 复合保温措施对腹腔镜全子宫切除术病人术中低体温及术后复苏期的影响[J]. 蚌埠医学院学报,2019,44(7):966-969. [5] 马吉宁,梁宵,王志萍,等. 不同保温措施对全麻下经尿道前列腺电切术患者低体温的治疗效果观察[J]. 徐州医科大学学报,2020,40(4):281-286. [6] 张曼曼,段红香,周晓阳,等. 降低神经外科全麻手术患者术中低体温发生率的PDCA实践[J]. 护理学报,2021,28(12):10-15. [7] 国家麻醉专业质量控制中心,中华医学会麻醉学分会. 围手术期患者低体温防治专家共识(2017)[J]. 协和医学杂志,2017,8(6):352-358. [8] 王福玲. 世界医学会《赫尔辛基宣言》[J]. 中国医学伦理学,2016,29(3):544-546. [9] 刘雨睿,王勇,李静静,等.2022年美国麻醉医师协会《困难气道管理实践指南》解读[J]. 临床麻醉学杂志,2022,38(6):643-647. [10] Sarvi JY,Gardhouse SM,Berke KA,et al.A three-portal laparoscopic hysterectomy in a chimpanzee(pan troglodytes)with a uterine manipulator and vessel sealing device[J]. Vet Surg,2022,51(7):1167-1174. [11] 安晓华,邱服斌,高哲慧,等. 体质指数对腹腔镜全子宫切除术中病人低体温发生率的影响[J]. 护理研究,2021,35(12):2242-2244. [12] 吴瑶,李亚玲,李建长. 右美托咪定对全身麻醉下腹腔镜子宫切除术中血流动力学及应激反应的影响[J]. 临床和实验医学杂志,2020,19(10):1108-1113. [13] 陶金冉,翟惠虹,邢洁,等. 全身麻醉下内镜黏膜下剥离术中低体温的影响因素分析[J]. 中华消化内镜杂志,2018,35(12):931-933. [14] 李爱华,石孙君,候芳,等. 手术室患者体温管理与患者全麻术后苏醒的相关性[J]. 海南医学,2019,30(9):1222-1224. [15] 钮敏红,龚喜雪,卢梅芳. 影响子宫内膜异位症腹腔镜手术患者术中低体温相关因素分析及预防对策[J]. 中国妇幼保健,2021,36(23):5406-5409. [16] 张淼,胡宪文,李锐,等. 全身麻醉术后患者苏醒室内低体温发生率及其影响因素的Logistic回归分析[J]. 现代生物医学进展,2021,21(7):1379-1382. [17] 史卓颖,张海伟,杜祥飞. 全身麻醉病人术中低体温发生预测模型的建立[J]. 护理研究,2021,35(2):246-249. [18] 孙亮,高倩,王广,等. 麻醉后恢复室期间全身麻醉患者发生低体温的影响因素[J]. 中华医学杂志,2021,101(1):52-56. [19] 陈颖,王莹,张越伦,等. 全麻患者围手术期低体温风险预测模型的前瞻性、多中心研究[J]. 中国医学科学院学报,2022,44(6):1028-1032. [20] 陈思宇,薄禄龙,徐文,等. 全身麻醉患者苏醒室内低体温发生情况及危险因素研究[J]. 临床军医杂志,2019,47(4):335-337,341. [21] 赵丹,杨秀梅,何玉杰. 子宫内膜癌患者腹腔镜术中低体温发生的影响因素分析及预测模型构建[J]. 中华现代护理杂志,2021,27(17):2331-2335. [22] 陈怀颖,苏丽静. 妇科腹腔镜手术患者术中低体温发生率及影响因素分析[J]. 中国内镜杂志,2021,27(5):46-51. [23] 马国岭. 腹腔镜全子宫切除术中低体温发生状况及影响因素分析[J]. 中国妇幼保健,2020,35(15):2777-2779. [24] 林守镇,陈丹丹. 腹腔镜子宫切除术中低体温影响因素分析[J]. 中国妇幼保健,2021,36(6):1360-1362. [25] 叶青青,陈悦,吴浩,等. 老年患者全身麻醉腹腔镜下子宫切除术中低体温发生情况及危险因素[J]. 局解手术学杂志,2023,32(2):125-128. |
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