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中国防痨杂志 ›› 2019, Vol. 41 ›› Issue (4): 426-429.doi: 10.3969/j.issn.1000-6621.2019.04.011

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  1. 101149 首都医科大学附属北京胸科医院 北京市结核病胸部肿瘤研究所麻醉科
  • 收稿日期:2019-01-13 出版日期:2019-04-10 发布日期:2019-04-08
  • 通信作者: 李凌海
  • 基金资助:

Risk factors for development of intraoperative hypothermia in patients undergoing spinal tuberculosis surgery

Ling-hai LI(),Da-qing YU,Chun WANG,Tao LIU,Zhi-guo SHI   

  1. Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
  • Received:2019-01-13 Online:2019-04-10 Published:2019-04-08
  • Contact: Ling-hai LI


目的 分析脊柱结核手术患者术中出现低体温的影响因素。方法 采用回顾性分析方法,选择2015年1月至2018年10月,北京胸科医院行脊柱结核手术的200例患者作为研究对象,包括前路病灶清除并植骨融合+内固定术52例,后路病灶清除并植骨融合+内固定术148例。根据患者术中否发生低体温将患者分为低体温组(91例)和非低体温组(109例)。收集患者临床资料、术中液体总入量(含输血量)、麻醉时间和方式、手术持续时间和术式等资料。采用多因素logistic回归分析患者术中出现低体温的危险因素。结果 200例患者中有91例术中发生低体温,发生率为45.5%,体温最低为33.7℃。低体温组行开胸手术者31例(34.07%),非低体温组行开胸手术者18例(16.51%),两组比较差异有统计学意义。logistic回归分析显示,脊柱结核患者行开胸手术者术中出现低体温的风险是未行开胸手术者的2.17倍(95%CI:1.09~4.33)。结论 开胸是脊柱结核手术患者术中低体温的危险因素。

关键词: 结核, 脊柱, 外科手术, 体温变化, 危险因素, 病例对照研究


Objective To identify the risk factors for the development of intraoperative hypothermia in the patients undergoing spinal tuberculosis surgery. Methods A retrospective study was conducted by collecting information and data from 200 patients who underwent spinal tuberculosis surgery in Beijing Chest Hospital from January 2015 to October 2018. Among them, 52 cases underwent anterior debridement and bone graft fusion+internal fixation and 148 cases underwent posterior debridement and bone graft fusion+internal fixation. The patients were divided into hypothermia group (91 cases) or non-hypothermia group (109 cases) according to whether or not intraoperative hypothermia occurred. Factors including the patient characteristics, the total amount of fluid infused (including the volume of blood transfused), duration and way of anesthesia, and duration and type of surgery were collected. The risk factors associated with intraoperative hypothermia were identified by multivariate logistic regression analysis. Results Among the 200 patients, 91 developed hypothermia during surgery, and the occurrence rate of hypothermia was 45.5%. The lowest body temperature was 33.7℃. There were 31 cases (34.07%) underwent open thoracotomy in the hypothermia group, and 18 cases (16.51%) in the non-hypothermia group. The difference between two groups was statistically significant. Logistic regression analysis revealed that the risk of developing hypothermia in spinal tuberculosis patients who underwent open thoracotomy was 2.17 times that of those who did not undergo open thoracotomy (95%CI: 1.09-4.33). Conclusion Open thoracotomy is a risk factor of hypothermia in the patients undergoing spinal tuberculosis surgery.

Key words: Tuberculosis, spinal, Surgical procedures, operative, Body temperature changes, Risk factors, Case-control studies