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| 剖宫产产妇术中寒战的危险因素 |
| Risk factors of intraoperative shivering in puerpera undergoing cesarean section |
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| DOI：10.12089/jca.2022.08.012 |
| 中文关键词: 剖宫产 寒战 危险因素 |
| 英文关键词: Cesarean section Shivering Risk factors |
| 基金项目: |
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| 中文摘要: |
目的 探讨剖宫产产妇术中寒战的危险因素。
方法 回顾性分析2018年1月至2021年12月行子宫下段剖宫产术产妇2 808例的临床资料，年龄22~48岁，ASA Ⅰ或Ⅱ级。收集产妇信息和术中寒战发生情况，并且通过手麻系统中不良事件登记的寒战程度分级（Wrench分级）评估术中寒战的程度。根据Wrench分级评分将产妇分为两组：寒战组（Wrench分级评分≥1分）和非寒战组（Wrench分级评分=0分）。采用单因素和多因素Logistic回归分析筛选剖宫产产妇发生术中寒战的危险因素。
结果 发生术中寒战的产妇有673例（23.96%）。单因素分析显示，BMI、手术时间、胎儿剖出时间、手术室温度、补液量、液体丢失量、消毒碘伏温度、术中有无使用加温毯、右美托咪定与剖宫产产妇发生术中寒战有关(P<0.05)。多因素Logistic回归分析显示，BMI（<23.5 kg/m2，OR=1.231，95%CI 1.101~1.376，P=0.026）、手术室温度（<21 ℃，OR=1.826，95%CI 1.303~2.561，P<0.001）、术中未使用加温毯（OR=2.682，95%CI 1.493~4.831，P<0.001）以及术中未使用右美托咪定（OR=1.225，95%CI 1.184~1.269，P=0.003）为发生术中寒战的独立危险因素。
结论 产妇BMI偏小、手术室温度偏低、术中未使用加温毯以及术中未使用右美托咪定是剖宫产产妇发生术中寒战的危险因素。 |
| 英文摘要: |
Objective To explore the risk factors of intraoperative shivering in puerpera undergoing cesarean section.
Methods A retrospective analysis was conducted on 2 808 puerpera who underwent cesarean section from January 2018 to December 2021, aged 22-48 years, and ASA physical status Ⅰ or Ⅱ. Maternal information and the occurrence of intraoperative shivering were collected, and the degree of intraoperative shivering was assessed by the shivering degree classification (Wrench grade) registered in the adverse events. The puerpera were divided into two groups according to the score of Wrench grade: the shivering group (Wrench grade ≥ 1) and the non shivering group (Wrench grade = 0). Univariate and multivariate Logistic regression analysis were used to screen the risk factors of shivering during cesarean section.
Results There were 673 (23.96%) puerpera who developed shivering. Univariate analysis showed that BMI index, operation time, fetal delivery time, operation room temperature, fluid replacement volume, fluid loss, iodophor temperature, use of heating blanket and dexmedetomidine had significant relations with shivering (P < 0.05). Multivariate Logistic regression showed that BMI index (<23.5 kg/m2, OR=1.231, 95% CI 1.101-1.376, P = 0.026), operating room temperature (<21 ℃, OR = 1.826, 95% CI 1.303-2.561, P < 0.001), no use of heating blanket (OR = 2.682, 95% CI 1.493-4.831, P < 0.001) and dexmedetomidine (OR = 1.225, 95% CI 1.184-1.269, P=0.003) were independent risk factors of shivering in cesarean section.
Conclusion Low BMI, low operating room temperature, no heating blanket, and no use of dexmedetomidine were the risk factors of shivering in puerpera undergoing cesarean section. |
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