首页|术前不同营养状况对腹腔镜下胃肠肿瘤根治手术老年患者术中意外低体温的影响及其危险因素分析

术前不同营养状况对腹腔镜下胃肠肿瘤根治手术老年患者术中意外低体温的影响及其危险因素分析

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目的 分析术前不同营养状况对腹腔镜下胃肠肿瘤根治手术老年患者术中意外低体温的影响及其危险因素。方法 回顾性分析2021年2月至2023年12月在南京医科大学第四附属医院行腹腔镜下胃肠肿瘤根治手术的282例老年患者的临床病例资料。采用微型营养状况评定简表(MNA-SF)评估患者术前营养状况,统计术中意外低体温发生情况,单因素和多因素logistic回归分析影响因素。结果 282例患者中104例(36。88%)发生术中意外低体温,合并营养不良或营养不良风险患者术中意外低体温发生率明显高于营养状况正常患者(P<0。05)。多因素logistic回归分析显示,年龄≥70岁、BMI<18。5 kg/m2、术前出现进行性体重下降、术前MNA-SF评分<12分、CO2气腹时间>4 h和合并低白蛋白血症是腹腔镜下胃肠肿瘤根治手术老年患者发生术中意外低体温的独立危险因素(P<0。05),而术中使用加温仪主动保温是避免发生术中意外低体温的独立保护因素(P<0。05)。结论 营养状况较差的老年患者行腹腔镜下胃肠肿瘤根治手术更容易发生术中意外低体温,其影响因素较多,应密切关注。
Effect of different preoperative nutritional statuses on intraoperative unexpected hypothermia in elderly patients with laparoscopic gastrointestinal tumor radical operation and its risk factors analysis
Objective To analyze the effect of preoperative nutritional status on the intraoperative un-expected hypothermia in elderly patients with laparoscopic gastrointestinal tumor radical operation and its risk factors.Methods The clinical case data in 282 elderly patients with laparoscopic gastrointestinal tumor radical surgery in the Fourth Affiliated Hospital of Nanjing Medical University from February 2021 to December 2023 were analyzed retrospectively.The mini nutritional assessment short form(MNA-SF)was adopted to e-valuate the preoperative nutritional status of the patients.The intraoperative unexpected hypothermia occur-rence were statistically analyzed.The univariate and multivariate logistic regression was used to analyze the in-fluencing factors.Results Among 282 patients,104 cases(36.88%)had unexpected hypothermia during op-eration.The incidence rate of intraoperative unexpected hypothermia in the patients with complicating malnu-trition or malnutritional risk was significantly higher than that in the patients with normal nutritional status(P<0.05).The multivariate logistic regression analysis showed that the age ≥70 years old,body mass index(BMI)<18.5 kg/m2,progressive weight loss appearance before surgery,preoperative MNA-SF score<12 points,CO2 pneumoperitoneum time>4 h and complicating hypoalbuminemia were the independent risk fac-tors for intraoperative unexpected hypothermia occurrence in the elderly patients with laparoscopic gastroin-testinal tumor radical operation(P<0.05),while the use of heating device for initiatively maintaining tem-perature during surgery was the protective factor for avoiding intraoperative unexpected hypothermia occur-rence(P<0.05).Conclusion The elderly patients with poor nutritional status undergoing laparoscopic gas-trointestinal tumor radical surgery are more likely to develop unexpected hypothermia.There are many influ-encing factors,so close attention should be paid to.

nutritional statuslaparoscopic gastrointestinal tumor surgeryelderly patientsunexpected hypothermiainfluence factor

杨玉春、胡玉萍、翁立阳、梁婷婷、戴体俊

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南京医科大学第四附属医院麻醉科,南京 210031

徐州医科大学麻醉药理学教研室,江苏徐州 221004

营养状况 腹腔镜下胃肠肿瘤手术 老年患者 意外低体温 影响因素

国家自然科学基金项目江苏省南京市卫生科技发展项目

30872432YKK20250

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(19)
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