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

Abstract:

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