目的:低体温是剖宫产术后常见的并发症之一,严重影响孕妇术中手术安全和术后恢复。减轻剖宫产孕妇低体温的危险因素,可降低其发生概率,提高孕妇围手术期舒适度。因此,本研究系统评价剖宫产患者低体温的影响因素,旨在为剖宫产产妇低体温的预防提供参考。
方法:在各种数据库中进行了系统搜索,包括PubMed,科克伦图书馆,Embase,WebofScience,中国国家知识基础设施(CNKI),万方,和中国生物医学文献数据库收集关于影响剖宫产孕妇体温过低因素的观察性研究。搜索截止日期为2024年1月30日。两名研究人员独立筛选文献,提取的数据,评估质量,交叉检查了结果。采用RevMan5.3和Stata17.0进行Meta分析。
结果:本综述纳入了12项研究,所有研究均为2014-2022年进行的病例对照研究,共纳入5,561名孕妇.纳入的研究质量为平均或以上。荟萃分析结果显示,体重指数(均差(MD)=-1.47;95%置信区间(CI)[-2.84,-0.11];p=0.03),手术室温度(比值比(OR)=2.08;95%CI[1.56,2.76];p<0.00001),麻醉方法(OR=1.84;95%CI[1.40,2.42];p<0.0001),流体损失(MD=160.09;95%CI[77.31,242.87];p=0.0002),冲洗体积(MD=66.43;95%CI[8.46,124.40];p=0.02),和甲状腺功能减退(OR=2.29;95%CI[1.61,3.27];p<0.00001)是剖宫产孕妇围手术期低体温的危险因素(p<0.05)。
结论:孕妇围手术期发生低体温受低体重指数等因素的影响,脊髓麻醉,低手术室温度,术中液体流失,冲洗量大,和甲状腺功能减退。
OBJECTIVE: Hypothermia is one of the common complications of cesarean section, which has a serious impact on intraoperative surgical safety and postoperative recovery of pregnant women. Mitigation of the risk factors of hypothermia in pregnant women undergoing cesarean section may reduce the probability of its occurrence and improve the perioperative comfort of pregnant women. Therefore, this study systematically evaluates the influencing factors of hypothermia in patients undergoing cesarean section, aiming to provide references for the prevention of hypothermia in pregnant women undergoing cesarean section.
METHODS: A systematic search was conducted across various databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Chinese Biomedical Literature databases to gather observational studies on the factors affecting hypothermia in pregnant women undergoing cesarean section. The search deadline was January 30, 2024. Two researchers independently screened literature, extracted data, evaluated quality, and crosschecked the outcomes. Meta analysis was conducted using RevMan 5.3 and Stata17.0.
RESULTS: Twelve studies were included in this review, all of which were case-control studies conducted from 2014 to 2022, encompassing a total of 5561 pregnant women. The quality of the studies included was average or above. The meta-analysis results showed that body mass index (mean difference (MD) = -1.47; 95% confidence interval (CI) [-2.84, -0.11]; p = 0.03), operating room temperature (odds ratio (OR) = 2.08; 95% CI [1.56, 2.76]; p < 0.00001), anesthesia method (OR = 1.84; 95% CI [1.40, 2.42]; p < 0.0001), fluid loss (MD = 160.09; 95% CI [77.31, 242.87]; p = 0.0002), flushing volume (MD = 66.43; 95% CI [8.46, 124.40]; p = 0.02), and hypothyroidism (OR = 2.29; 95% CI [1.61, 3.27]; p < 0.00001) were risk factors for perioperative hypothermia in pregnant women undergoing cesarean section (p < 0.05).
CONCLUSIONS: The occurrence of hypothermia in pregnant women during the perioperative period is influenced by factors such as low body mass index, spinal anesthesia, low operating room temperature, intraoperative fluid loss, large flushing volume, and hypothyroidism.