周围手术温度管理和凝血:在前性研究中轻度低温的影响
Alena Trčková1, Tereza Bönischová1,2, Hana Zelinková3
1Department of Pediatric Anesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czechia.
Frontiers in medicine
|July 1, 2025
概括
轻度低温在儿科手术中很常见,但通常不会导致严重的出血问题. 低手术室温度和年龄较大是儿童体温下降的危险因素.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 凝血生理学 凝血生理学
- 在外科手术期间的医学.
背景情况:
- 周围手术性低温是儿童在全身或区域麻醉下进行手术的常见并发症.
- 低温是发展凝血障碍的一个已知的危险因素.
- 评估低温儿科患者的凝血病对患者的安全至关重要.
研究的目的:
- 评估在关节镜和开放腹部手术期间出现低温的儿科患者 (0-18岁) 发生凝血病的发生率.
- 在这个患者群体中识别导致低温和凝血病的危险因素.
主要方法:
- 一项前性队列研究 (Peritemp) 观察了102名儿科患者.
- 监测体温 (低于36.5°C和36°C) 和凝血参数 (ROTEM,aPTT,PT).
- 分析了低温和凝血病的发病率,以及相关的风险因素.
主要成果:
- 轻度低温 (低于36.0°C) 在43%的患者中发生;温度低于36.5°C在86%的患者中发生.
- 凝血测试异常范围为5.9%至32.4%,ROTEM异常为18.7%,标准测试异常为15.9%.
- 低操作室温度和年龄较大是低温的重要危险因素;只有PT-R在初始和后期测试之间显示出显著差异.
结论:
- 轻度低温在儿科手术中很常见,但通常被凝血系统很好地容忍,不会导致临床上显著的疾病.
- 除PT-R外,凝血参数没有显著变化,表明轻度低温可能不会严重影响儿科凝血.
- 手术室温度的变化与手术期间的低温有关;建议在不同儿科群体进行进一步的研究.
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