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中国的机器人外科学杂志 | ISSN 2096-7721 | CN 10-1650/R

机器人辅助根治性膀胱切除术患者采取术中体温管理后围术期低体温发生情况及其影响因素

Incidence of perioperative hypothermia and its influencing factors in patients undergoing robot-assisted radical cystectomy after intraoperative temperature management

作者:杨芳,蔺洁璐,王黎萍,王婷婷

Vol. 6 No. 1 Jan. 2025 DOI: 10.12180/j.issn.2096-7721.2025.01.022 发布日期:2025-02-10
关键词:膀胱癌;机器人辅助根治性膀胱切除术;术中体温管理;低体温;影响因素

作者简介:

目的:分析机器人辅助根治性膀胱切除术(RARC)患者采取术中体温管理后围术期低体温发生情况及其 影响因素。方法:选取 2018 年 3 月—2020 年 8 月西安市第三医院收治的 39 例行常规术中护理的 RARC 患者,将 其纳入对照组,另选取 2020 年 9 月—2023 年 3 月西安市第三医院收治的 39 例行术中保温护理的 RARC 患者, 将其纳入观察组。比较两组患者不同时点体温水平。结果:两组患者术中 1 h、3 h、5 h 体温低于术前,术中 5 h 体温高于术中 3 h,观察组术中 1 h、3 h、5 h 体温均高于对照组(P<0.05);观察组低体温发生率低于对照组 (P<0.05)。BMI < 24 kg/m2 、护理方式为常规术中护理、腹腔冲洗液量 >500 mL、术中补液量 >1500 mL 及手术时 间、气腹时间和麻醉时间长的患者低体温发生率高于 BMI ≥ 24 kg/m2 、护理方式为术中保温护理、腹腔冲洗液量 ≤ 500 mL、术中补液量≤ 1500 mL 及手术、气腹、麻醉时间短的患者(P<0.05)。二元 Logistic 回归分析结果显 示,手术时间和气腹时间长、腹腔冲洗液量 >500 mL、术中补液量 >1500 mL 是 RARC 患者围术期低体温发生的危 险因素(OR>1,P<0.05),采取术中体温管理是 RARC 患者围术期低体温发生的保护因素(OR<1,P<0.05)。 结论:术中体温管理能够有效稳定 RARC 患者术中体温,降低低体温发生率,且手术时间、气腹时间、腹腔冲洗液量、 术中补液量及护理方式是 RARC 患者围术期低体温发生的影响因素。

Objective: To analyze the incidence of perioperative hypothermia and its influencing factors in patients undergoing robot-assisted radical cystectomy (RARC) after intraoperative temperature management. Methods: 78 RARC patients in the Third Hospital of Xi’an from March 2018 to March 2023 were selected and divided into the control group (March 2018 to August 2020, routine intraoperative nursing, n=39) and the observation group (September 2020 to March 2023, intraoperative heat preservation nursing, n=39). Body temperatures of patients at different time points was compared between the two groups. Results: Body temperatures at intraoperative 1 h, 3 h and 5 h were lower than that before surgery, and the temperatures at intraoperative 5 h were higher than that at 3 h during surgery. Compared to the control group, the observation group demonstrated a lower incidence of hypothermia (P<0.05) and a higher temperature at 1 h, 3 h, and 5 h during surgery (P<0.05). The incidence of hypothermia was higher in patients with body mass index <24 kg/m2 , routine intraoperative nursing, abdominal lavage volume >500 mL, intraoperative rehydration volume >1500 mL, longer operative time, pneumoperitoneum time and anesthesia time than patients with body mass index≥24 kg/m2 , intraoperative warming nursing, abdominal lavage volume ≤500 mL, intraoperative rehydration volume ≤1500 mL, shorter operative time, pneumoperitoneum time and anesthesia time (P<0.05). Logistic regression results showed that long operative and pneumoperitoneum time, abdominal lavage volume >500 mL, and intraoperative rehydration volume >1500 mL were risk factors for perioperative hypothermia (OR>1, P<0.05), and intraoperative body temperature management was a protective factor in RARC patients (OR<1, P<0.05). Conclusion: Intraoperative temperature management can effectively stabilize the intraoperative body temperature and reduce the incidence of hypothermia. The operative time, pneumoperitoneum time, peritoneal lavage volume, intraoperative rehydration volume, and nursing methods are the influencing factors of perioperative hypothermia in RARC patients.

稿件信息

基金项目:陕西省重点研发计划项目(2017ZDXM-SF-045) 

Foundation Item: Key R&D Plan Project of Shaanxi Province (2017ZDXM-SF-045)  

通讯作者:王婷婷,Email:13892170870@139.com 

Corresponding Author: WANG Tingting, Email: 13892170870@139.com 

引用格式:杨芳,蔺洁璐,王黎萍,等 . 机器人辅助根治性膀胱切除术患者采取术中体温管理后围术期低体温发生情况及其影响 因素 [J]. 机器人外科学杂志(中英文),2025,6(1):128-133. 

Citation: YANG F, LIN J L, WANG L P, et al. Incidence of perioperative hypothermia and its influencing factors in patients  undergoing robot-assisted radical cystectomy after intraoperative temperature management [J]. Chinese Journal of Robotic  Surgery, 2025, 6(1): 128-133.

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