在全身麻醉期间婴儿手术内低温的危险因素:一项回顾性研究
Yi Gao1, Jiabin Fan, Jialian Zhao
1Department of Anesthesiology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China.
Medicine
|September 1, 2023
概括
在接受全身麻醉的婴儿中,近一半的婴儿会出现手术内低温症 (IH). 风险因素包括新生儿,更长的手术和更高的美国麻醉学会 (ASA) 评分,而预热可以降低风险.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 婴儿外科手术的结果
- 儿童体温调节的方法
背景情况:
- 术内低温 (IH) 是儿科手术的一个重大问题.
- 婴儿,特别是新生儿和早产婴儿,更容易受到温度失调的影响.
- 了解IH发病率,风险因素和结果对于改善患者安全至关重要.
研究的目的:
- 为了确定在接受全身麻醉的婴儿中手术内低温 (IH) 的发生率.
- 评估与该人群中IH相关的风险因素.
- 评估与婴儿IH相关的结果和并发症.
主要方法:
- 对754名在全身麻醉下 (<1岁) 婴儿的前性收集数据的回顾性分析.
- 记录了手术期间的温度,手术/麻醉的细节,以及术后的结果.
- 后勤回归用于确定IH的重大风险因素.
主要成果:
- IH (<36°C) 在47.88%的婴儿中发生;严重低温 (<35°C) 在15.4%中发生.
- 风险因素包括新生儿状况 (OR=3.685),较高的ASA得分 (OR=3.418),增加液体给药量 (>20毫升/公斤,OR=2.380),以及较长的手术 (>60分钟,OR=1.785).
- 较低的体重 (OR=0.599) 和预热 (OR=0.027) 是保护性的. 肠道炎症与更长的住院时间和术后出血增加有关.
结论:
- 接受全身麻醉的婴儿患上IH的发病率很高,新生儿和经历了较长时间手术的婴儿有更高的风险.
- 诸如较高的ASA分类,增加的液体管理和缺乏预热等因素显著增加了IH风险.
- 肠道炎症与不良结果有关,包括长时间住院和增加出血,强调了预防措施 (如预热) 的重要性.
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