麻醉诱导前低体温的发生率及相关影响因素的研究

Incidence and influencing factors of hypothermia before anesthesia induction

摘要:

探究麻醉诱导前围手术期低体温发生情况及相关的影响因素。方法收集2015 年6 月-2016 年1 月在该院住院接受手术治疗的患者一般资料，经过筛选确定622 例患者为研究对象。依据麻醉诱导前体核体温是否低于36℃分为低体温组和正常体温组。统计分析两组患者的性别、年龄、身高、体重、体重指数（BMI）、去脂体重（LBW）、脂肪比（AR），并对这些因素依次进行单因素、多因素分析，寻找对导致麻醉诱导前低体温出现的因素进行多因素分析，寻找麻醉诱导前低体温的独立危险因素。结果对两组患者的一般资料进行单因素分析显示：低体温组患者年龄、女性患者比例、LBW 高于正常组；体重和BMI 低于正常组，差异有统计学意义（p <0.05）。同时，多因素Logstic回归分析显示女性（OR =1.353）和年龄（OR =1.151）是麻醉诱导前低体温独立影响因素，差异有统计学意义（ p=0.011 和0.022）。在此基础上，相关性分析结果显示女性患者麻醉术前体温与年龄呈负相关（r =-0.663，p =0.021），并且x2检验结果也表明45 岁以上的女性术前低体温的发生率高于年轻患者（ p=0.001）。结论女性以及年龄是麻醉诱导前低体温的危险因素，并且更年期阶段妇女的发生率上升明显，因此对于更年期女性以及老年患者需警惕麻醉诱导前低体温的发生，术前做好预防低体温发生的措施。

Abstract:

To explore the incidence of hypothermia before induction of anesthesia and its influencing factors. Methods In total, 622 patients treated in our hospital from June 2015 to January 2016 were involved in the study. They were divided into low temperature group (118 cases, T < 36℃) and normal body temperature group (504 cases) according to their body temperature before induction of anesthesia. The gender, age, height, weight, BMI, AR and LBW of the two groups were carefully collected, and univariate and multivariate logistic analyses were used to look for the influencing factors of hypothermia before induction of anesthesia. Results Compared to the normal temperature group, the age was older, the percentage of female patients and LBW were higher but the weight and BMI were lower in the low temperature group (p < 0.05). According to univariate logistic analysis, male, age, BMI and LBW were associated with hypothermia before anesthesia induction. On this bases, multivariate logistic regression analysis showed that female (OR= 1.353) and older age (OR= 1.151) were the independent influencing factors of hypothermia before induction of anesthesia (p < 0.05). A further subgroup analysis of female patients in thehypothermia group showed that the body temperature had a negative correlation with age ( p< 0.05). What's more, chi-square test showed that female patients over the age of 45 had higher incidence of hypothermia before induction of anesthesia (p < 0.05). Conclusions Female and age are the independent risk factors of hypothermia before induction of anesthesia, and the incidence significantly increases in climacteric women. Therefore, measures should be taken to prevent hypothermia before induction of anesthesia, especially in climacteric women and elder patients.