【摘要】 目的 探究腹腔镜胃肠肿瘤患者术后麻醉复苏期低体温发生的影响因素，构建预测模型。方法 选取行腹腔镜手术的胃肠肿瘤患者360例，根据术后是否发生低体温将其分为低体温组（n=124）和正常体温组（n=236）。采用多因素logistic回归模型筛选腹腔镜胃肠肿瘤患者术后并发低体温的危险因素，并构建风险预测模型，采用受试者工作特征曲线（ROC）检验模型的预测性能。结果 logistic回归分析显示高龄、美国麻醉医师协会（ASA）分级≥Ⅲ级、麻醉时长≥2 h、术中输液量>1 200 mL是腹腔镜胃肠肿瘤患者术后低体温发生的危险因素（OR分别=1.31、2.51、3.02、1.90,P均<0.05）；体重指数（BMI）≥24 kg/m~2、基础体温≥36.5℃是其保护因素（OR分别=0.71、0.58,P均<0.05）。Hosmer-Lemeshow检验预警模型具有良好的拟合度（χ~2=6.19,P>0.05）；模型ROC曲线下面积为0.86,95%CI为0.82～0.90。结论 胃肠肿瘤患者腹腔镜术后低体温发生的与年龄、BMI、ASA分级、麻醉时间、术中输液量、基础体温有关；构建的模型具有良好的预测效能，可科学、直观、简便的识别存在术后低体温风险的胃肠肿瘤手术患者。更多还原

【Abstract】 Objective To explore the risk factors hypothermia during anesthesia recovery period after laparoscopic gastrointestinal tumor surgery,thus to construct the risk predictive model. Methods Gastrointestinal tumor patients who underwent laparoscopic surgery were selected as the research subjects.They were divided into a hypothermia group and a normal temperature group based on whether they experienced hypothermia after surgery.Using a multiple logistic regression model to screen for undergoing laparoscopic surgery,predictive performance of the model was analyzed by receiver operating characteristic curve(ROC). Results Logistic regression analysis showed that old age,ASA grade Ⅲ,anesthesia duration of 2h,intraoperative infusion volume> 1 200mL were independent risk factors for postoperative hypothermia in laparoscopic gastrointestinal tumors(OR=1.31,2.51,3.02,1.90,P<0.05).BMI≥24kg/m~2 and basal temperature ≥36.5 ℃ were the protective factors(OR=0.71,0.58,P<0.05).The Hosmer-Lemeshow test showed that the warning model had a good fit（χ~2=6.19,P>0.05）,the area under the ROC curve of the model was 0.86,the 95% CI was 0.82-0.90.Conclusion The occurrence of postoperative hypothermia in patients with gastrointestinal tumors undergoing laparoscopic surgery is related to age,BMI,ASA grade,anesthesia time,intraoperative infusion volume,and basal body temperature.The constructed model has good predictive performance and can scientifically,intuitively,and simply identify gastrointestinal tumor surgical patients who has risk of postoperative hypothermia.更多还原