【罂粟摘要】大量外科患者群体中新发术中体温过高：一项回顾性的观察性研究
大量外科患者群体中新发术中体温过高：一项回顾性的观察性研究
贵州医科大学 高鸿教授课题组
翻译：佟睿 编辑：佟睿 审校：曹莹
术中体温过低已被广泛研究。然而，术中体温过高的发生率尚未得到详细调查。
这项研究的主要目的是评估在大量外科患者群体中新发术中体温过高的发生率和危险因素。
回顾数据库综述。
三级医疗教学医院。
纳入2002年1月1日至2017年12月31日期间在全身麻醉下接受手术的患者。
主要观察指标是新发的术中体温过高(>37.5℃)。采用Logistic回归模型确定术中体温过高的危险因素。
共纳入103648名患者进行最终分析。新发术中体温过高的发生率为6.45%，在长时间(>8h)手术后可达到20%~30%，在儿科患者中高达26.5%。应用热风毯加温、大量输液、较长的手术时间、较小的年龄和较小的体型都与术中体温过高独立相关。外科护理改善项目(SCIP)温度措施的采用与术中体温过高的发生率增加有关。
术中轻度体温过高并不少见，特别是在较长的手术时间和较小的儿童中。
New-onset intra-operative hyperthermia in a large surgical patient population: A retrospective observational study
Abstract
BACKGROUND Intra-operative hypothermia has been extensively investigated. However, the incidence of intraoperative hyperthermia has not been investigated in detail.
OBJECTIVE The main objective of this study was to assess the incidence and risk factors of new-onset intra-operative hyperthermia in a large surgical patient population.
DESIGN Retrospective database review.
SETTING Tertiary-care teaching hospital.
PATIENTS Patients undergoing surgery with general anaesthesia between 1 January 2002 and 31 December 2017 were included.
MAIN OUTCOME MEASURES The primary outcome measurement was new-onset intra-operative hyperthermia (>37.5℃). A logistic regression model was fitted to identify risk factors for intra-operative hyperthermia.
RESULTS A total of 103 648 patients were included in the final analyses. The incidence of new-onset hyperthermia in the overall patient cohort was 6.45%, reaching 20 to 30% after prolonged (>8 h) surgery, and was up to 26.5% in paediatric patients. The use of forced air active patient warming, larger amounts of fluid administration, longer surgery, younger age and smaller body size were all independently associated with intra-operative hyperthermia. The adoption of the Surgical Care Improvement Project (SCIP) temperature measures was associated with an increased incidence of intra-operative hyperthermia.
CONCLUSION Mild intra-operative hyperthermia is not uncommon particularly in longer procedures and small children.