Analysis of hypothermia factors for elderly patients with malnutrition during proximal femoral nail antirotation internal fixation under general anesthesia

FAN Qian-nan; YAN Zhi-yong; WU Hao; LIU Jing-ying; GENG Ying; DAI Ti-jun

doi:10.11659/jjssx.03E023068

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Analysis of hypothermia factors for elderly patients with malnutrition during proximal femoral nail antirotation internal fixation under general anesthesia

Clinical Research | 更新时间：2024-02-02

- Analysis of hypothermia factors for elderly patients with malnutrition during proximal femoral nail antirotation internal fixation under general anesthesia
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 2, Pages: 145-148(2024)
- 作者机构：
  
  1.南京医科大学附属宿迁第一人民医院麻醉科，江苏宿迁 223800
  2.徐州医科大学麻醉药理学教研室，江苏徐州 221004
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.03E023068
  CLC： R683.4
- Published：25 February 2024，
  
  Received：12 March 2023，
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樊倩楠,严志勇,吴浩等.老年营养不良患者全身麻醉下股骨近端防旋髓内钉内固定术中低体温因素分析[J].局解手术学杂志,2024,33(02):145-148.

FAN Qian-nan,YAN Zhi-yong,WU Hao,et al.Analysis of hypothermia factors for elderly patients with malnutrition during proximal femoral nail antirotation internal fixation under general anesthesia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(02):145-148.
樊倩楠,严志勇,吴浩等.老年营养不良患者全身麻醉下股骨近端防旋髓内钉内固定术中低体温因素分析[J].局解手术学杂志,2024,33(02):145-148. DOI： 10.11659/jjssx.03E023068.

FAN Qian-nan,YAN Zhi-yong,WU Hao,et al.Analysis of hypothermia factors for elderly patients with malnutrition during proximal femoral nail antirotation internal fixation under general anesthesia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(02):145-148. DOI： 10.11659/jjssx.03E023068.

摘要

目的

分析全身麻醉下行股骨近端防旋髓内钉（PFNA）内固定术的老年营养不良患者术中低体温的发生情况及其危险因素。

方法

选取全身麻醉下行PFNA内固定术的老年患者139例，术前1 d的营养状况评分为0~11分。对可能导致患者发生术中低体温的相关因素行单因素及多因素

Logistic

二元回归分析。

结果

术前营养评分0~11分的139例老年患者中，有79例（56.83%）发生了术中低体温。单因素及多因素

Logistic

二元回归分析结果提示：年龄≥75岁、MNA-SF营养评分0~7分、BMI

18.5 kg/m

、全身麻醉时间≥2 h、术中冲洗液量≥1 000 mL及术中补液量≥1 000 mL是导致老年患者发生术中低体温的危险因素（

1，

0.05），而术中使用加温毯保温是避免发生术中低体温的保护因素（

1，

0.05）。

结论

术前营养不良的老年患者全身麻醉下行PFNA内固定术中低体温发生率较高，营养状况较差的患者更容易发生术中低体温，患者年龄较大、营养状况较差、BMI较低、全身麻醉时间较长、术中冲洗液量及补液量较多容易导致术中低体温的发生，而使用加温毯可以降低术中低体温的发生率。

Abstract

Objective

To analyze the incidence and risk factors of hypothermia in elderly patients with malnutrition during proximal femoral nail antirotation （PFNA） internal fixation under general anesthesia.

Methods

A total of 139 elderly patients underwent PFNA internal fixation under general anesthesia were selected，and the nutritional status scores 1 day before surgery ranged from 0 to 11 points. Univariate and multivariate

Logistic

binary regression analysis was performed to analyze the related factors that may lead to intraoperative hypothermia.

Results

Among 139 elderly patients with preoperative nutritional scores of 0 to 11 points，79 cases （56.83%） developed intraoperative hypothermia. The results of univariate and multivariate

Logistic

binary regression analysis suggested that age≥75 years old，mini nutritional assessment short form （MNA-SF） nutritional score 0 to 7 points，BMI

18.5 kg/m

，duration of general anesthesia ≥2 hours，intraoperative flushing fluid volume≥1 000 mL and intraoperative fluid volume≥1 000 mL were the risk factors for the occurrence of intraoperative hypothermia in elderly patients （

1，

0.05）. The use of warm blanket insulation was the protective factor against the occurrence of intraoperative hypothermia （

1，

0.05）.

Conclusion

The incidence of intraoperative hypothermia during PFNA internal fixation under general anesthesia in elderly patients with mainutrition before operation is high，and patients with poor nutritional status are more likely to develop intraoperative hypothermia. Patients with older age，poor nutritional status，lower BMI，longer duration of general anesthesia，and more intraoperative flushing fluid volume and intraoperative fluid volume are likely to lead to intraoperative hypothermia. The use of warm blanket can reduce the incidence of intraoperative hypothermia.

关键词

营养不良股骨近端防旋髓内钉内固定术老年术中低体温危险因素

Keywords

malnutritionproximal femoral nail antirotationinternal fixationelderlyintraoperative hypothermiarisk factor

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