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新生儿坏死性小肠结肠炎术中低体温对近期预后的影响OA

Effect of intraoperative hypothermia on short-term prognosis in neonatal necrotizing enterocolitis

中文摘要英文摘要

目的 探究新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)术中低体温对近期预后的影响.方法 回顾性收集2017年6月—2023年8月重庆医科大学附属儿童医院150例NEC手术患儿的资料.按术中最低体温分为正常体温组(≥36.0℃,49例)、轻度低体温组(35.0~35.9℃,73例)、中度低体温组(34.0~34.9℃,20例)和重度低体温组(<34.0℃,8例),分析低体温对预后的影响.结果 150例患儿中,101例(67.3%)发生术中低体温.轻度低体温显著增加了术后凝血功能障碍的发生风险(OR=2.170,95%CI:1.035~4.552,P<0.05).轻度低体温(B=12.250,95%CI:1.176~23.324,P<0.05)和重度低体温(B=24.510,95%CI:1.645~47.376,P<0.05)均显著延长了术后住院时长,而中度低体温显著增加了中心静脉置管时长(B=11.388,95%CI:1.625~21.15,P<0.05).结论 NEC手术患儿术中低体温发生率高,且不同程度低体温对近期预后的影响存在差异.临床需重视术中体温管理,采取主动保温措施改善预后.

Objective To investigate the effect of intraoperative hypothermia on short-term prognosis in neonates with necrotizing enterocolitis(NEC)undergoing surgery.Methods Clinical data of 150 neonates with NEC who underwent surgery at Children's Hospital of Chongqing Medical University from June 2017 to August 2023 were retrospectively collected.Based on the lowest intraoperative temperature,patients were classified into a normothermia group(≥36.0℃,n=49),a mild hypothermia group(35.0-35.9℃,n=73),a moderate hypothermia group(34.0-34.9℃,n=20),and a severe hypothermia group(<34.0℃,n=8).Postoperative outcomes were analyzed across groups.Results Intraoperative hypothermia occurred in 101/150(67.3%)neonates.Mild hypothermia significantly increased the risk of postoperative coagulation disorders(OR=2.170,95%CI:1.035-4.552,P<0.05).Postoperative hospital stay was significantly prolonged in the mild(B=12.250,95%CI:1.176-23.324,P<0.05)and severe hypothermia groups(B=24.510,95%CI:1.645-47.376,P<0.05),while the duration of central venous catheterization was significantly increased in the moderate hypothermia group(B=11.388,95%CI:1.625-21.15,P<0.05).Conclusions Intraoperative hypothermia is common in neonates with NEC undergoing surgery,and different degrees of hypothermia are associated with distinct adverse effects on short-term prognosis.Intraoperative temperature management should be prioritized,and active warming measures should be implemented to improve outcomes.

冉芹;韦红;史源;王政力

重庆医科大学附属儿童医院新生儿科/儿童少年健康与疾病国家临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染与免疫罕见病重庆市重点实验室,重庆 400014重庆医科大学附属儿童医院新生儿科/儿童少年健康与疾病国家临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染与免疫罕见病重庆市重点实验室,重庆 400014||江西省妇幼保健院/江西儿童医学中心,江西 南昌 330000重庆医科大学附属儿童医院新生儿科/儿童少年健康与疾病国家临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染与免疫罕见病重庆市重点实验室,重庆 400014||江西省妇幼保健院/江西儿童医学中心,江西 南昌 330000重庆医科大学附属儿童医院新生儿科/儿童少年健康与疾病国家临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染与免疫罕见病重庆市重点实验室,重庆 400014||江西省妇幼保健院/江西儿童医学中心,江西 南昌 330000

坏死性小肠结肠炎术中低体温近期预后新生儿

Necrotizing enterocolitisIntraoperative hypothermiaShort-term prognosisNeonate

《中国当代儿科杂志》 2026 (5)

556-562,7

重庆市自然科学基金面上项目(CSTB2023NSCQ-MSX0178)江西省自然科学基金杰青项目(20242BAB23079).

10.7499/j.issn.1008-8830.2510016

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