Analysis of the influencing factors of the intraoperative hypothermia of patients during gynecological laparoscopic surgery and the prediction model establishment
Objective:To investigate the influencing factors of the intraoperative hypothermia(IPH)of patients during gynecological laparoscopic surgery.Methods:The clinical data of the patients with the gynecological laparoscopic sur-gery from March 2022 to March 2024 were selected in this study.According to the occurrence of IPH or not,these pa-tients were divided into group A(patients with IPH)and group B(patients without IPH).The body mass index(BMI),the interoperative body temperature,the intraoperative active body temperature preservation and the intraop-erative fluid volume of the patients in the two groups were collected.Logistic regression was used to analyze the influ-encing factors of the IPH occurrence of the patients during gynecological laparoscopic surgery.The predictive model for the IPH occurrence was constructed,and receiver operator characteristic(ROC)curve was drawn to evaluate the pre-dictive efficacy of this model for the IPH occurrence of the patients during gynecological laparoscopic surgery.Results:A total of 230 patients with gynecological laparoscopic surgery were enrolled in this study,including 2 cases with the laparotomy because of the laparoscopic surgery failure,1 case with the self-withdrawal from this study and 2 cases with the incomplete data collection,so finally,225 cases were included for analysis,and the incidence of IPH of the patients was 32.9％(74/225).Univariate analysis showed that there were significant differences in the basal body tem-perature,the intraoperative temperature,the intraoperative active body temperature preservation,the intraoperative fluid infusion volume,the intraoperative irrigation volume and the operation time of the patients between the two groups.Binary logistic analysis showed that the low basal body temperature,the low operating room temperature,the no active intraoperative body temperature preservation,the more intraoperative fluid infusion and irrigation volume,and the long operation time of the patients were the factors influencing their IPH occurrence during gynecological lapa-roscopic surgery(all P＜0.05).The prediction model was established based on these influencing factors,and the H-L test showed that the prediction model had a good goodness of fit.ROC curve analysis showed that the area under the curve,the sensitivity and the specificity of the model for predicting the IPH occurrence of the patients with gynecologi-cal laparoscopic surgery were 0.987,98.7％and 90.7％,respectively.Conclusion:The low basal body temperature,the low operating room temperature,the no active intraoperative body temperature preservation,the more intraopera-tive fluid infusion and irrigation volume,and the long operation time of the patients can all influence their IPH occur-rence during gynecological laparoscopic surgery,and the established model based on which has better efficacy for pre-dicting the IPH occurrence.The prevention and the nursing according to the prediction model can reduce the incidence of the IPH occurrence of the patients during gynecological laparoscopic surgery in clinic.
Gynecologic laparoscopic surgeryIntraoperative hypothermiaInfluencing factorsPrediction model
万方数据
维普
