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中华胃食管反流病电子杂志

中华胃食管反流病电子杂志 ›› 2024, Vol. 11 ›› Issue (01) : 47 -52. doi: 10.3877/cma.j.issn.2095-8765.2024.01.011

护理园地

术中体温水平对代谢综合征合并胃食管反流病行腹腔镜袖状胃切除联合胃底折叠术患者预后的影响
程晨1, 赵从1, 蒋媛2, 张丽1,†()   
  1. 1. 830011　乌鲁木齐，新疆维吾尔自治区人民医院中心手术室
    2. 830011　乌鲁木齐，新疆维吾尔自治区人民医院微创、疝与腹壁外科
  • 收稿日期:2023-11-29 出版日期:2024-02-15
  • 通信作者: 张丽
  • 基金资助:
    新疆维吾尔自治区人民医院院内项目(20210245)

Effect of intraoperative body temperature on the prognosis of patients with metabolic syndrome complicated with gastroesophageal reflux disease undergoing laparoscopic sleeve gastrectomy combined with fundoplication

Chen Cheng1, Cong Zhao1, Yuan Jiang2, Li Zhang1,†()   

  1. 1. Central Operating Room, Hernia and Abdominal Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830011, China
    2. Department of Minimally Invasive, Hernia and Abdominal Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830011, China
  • Received:2023-11-29 Published:2024-02-15
  • Corresponding author: Li Zhang
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程晨, 赵从, 蒋媛, 张丽. 术中体温水平对代谢综合征合并胃食管反流病行腹腔镜袖状胃切除联合胃底折叠术患者预后的影响[J/OL]. 中华胃食管反流病电子杂志, 2024, 11(01): 47-52.

Chen Cheng, Cong Zhao, Yuan Jiang, Li Zhang. Effect of intraoperative body temperature on the prognosis of patients with metabolic syndrome complicated with gastroesophageal reflux disease undergoing laparoscopic sleeve gastrectomy combined with fundoplication[J/OL]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(01): 47-52.

目的

探讨术中体温水平对代谢综合征合并胃食管反流病(GERD)行腹腔镜袖状胃切除术联合胃底折叠手术患者预后的影响。

方法

回顾性分析2020年3月至2023年3月，新疆维吾尔自治区人民医院微创、疝与腹壁外科收治的188例诊断为代谢综合征合并GERD并且行腹腔镜袖状胃切除联合胃底折叠手术患者的临床资料。采用Logistic回归法进行多因素分析术中体温水平对预后的影响，并运用受试者工作特征(ROC)曲线分析术中体温水平对患者预后的预测价值。

结果

并发症组患者的术中体温水平低于非并发症组，差异有统计学意义(36.48 ℃±0.24 ℃比36.67 ℃±0.22 ℃; P=0.002)。Logistic回归分析发现术中低体温是术后并发症发生的危险因素(P<0.05)，并且术中体温水平预测患者预后的ROC曲线下面积>0.7。

结论

术中低体温是代谢综合征合并GERD行腹腔镜袖状胃切除联合胃底折叠手术后并发症发生的危险因素，术中体温水平对预后具有较高的预测价值。

关键词: 代谢综合征, 胃食管反流病, 腹腔镜袖状胃切除术, 胃底折叠, 体温水平, 预后
Objective

To investigate the effect of intraoperative body temperature on the prognosis of patients with metabolic syndrome complicated with gastroesophageal reflux disease(GERD) undergoing laparoscopic sleeve gastrectomy combined with fundoplication.

Methods

The clinical data of 188 patients diagnosed as metabolic syndrome complicated with GERD who underwent laparoscopic sleeve gastrectomy combined with fundoplication from March 2020 to March 2023 in Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region were retrospectively analyzed. Logistic regression method was used to analyze the influence of intraoperative body temperature level on prognosis, and ROC curve was used to analyze the predictive value of intraoperative body temperature level on prognosis of patients.

Results

The intraoperative body temperature of patients with complications was lower than that of patients without complications(36.48 ℃ ± 0.24 ℃ vs 36.67 ℃ ± 0.22 ℃, P=0.002). Logistic regression analysis showed that intraoperative hypothermia was a risk factor for postoperative complications, and the AUC of intraoperative body temperature level in predicting the prognosis of patients was greater than 0.7.

Conclusion

Intraoperative hypothermia is a risk factor for complications after laparoscopic sleeve gastrectomy combined with fundoplication for metabolic syndrome complicated with GERD. Intraoperative hypothermia has high predictive value for prognosis.

Key words: Metabolic syndrome, Gastroesophageal reflux disease, Laparoscopic sleeve gastrectomy, Fundoplication, Body temperature level, Prognosis
表1 2组临床资料比较
临床资料 并发症组（15例） 非并发症组（173例） χ2/t值 P值
年龄(岁，) 36.73±10.68 35.64±8.78 0.454 0.650
性别[例(%)] 0.144 0.704
男性 7(46.7) 72(41.6)
女性 8(53.3) 101(58.4)
BMI(kg/m2，) 37.97±4.69 40.18±7.53 -1.118 0.265
合并症[例(%)] 3.957 0.047
是 6(40.0) 32(18.5)
否 9(60.0) 141(81.5)
吸烟史[例(%)] 0.621 0.431
是 7(46.7) 63（36.4）
否 8(53.3) 110（63.6）
酗酒史[例(%)] 4.373 0.037
是 5(33.3) 23（13.3）
否 10(66.7) 150（86.7）
ASA分级 5.203 0.023
I/II级 10(66.7) 152（87.9）
III/IV级 5(33.3) 21（12.1）
手术时间(min,) 170.80±8.08 163.41±11.87 2.361 0.019
出血量(ml,) 89.40±5.90 82.65±10.33 2.494 0.014
术中体温水平(℃,) 36.48±0.24 36.67±0.22 -3.182 0.002
表2 LSG手术预后危险因素的多因素Logistic回归分析
因素 β SE Wald χ2 P值 OR 95%CI
合并症 2.028 0.766 7.015 0.008 7.601 1.694~34.099
酗酒史 1.619 0.792 4.182 0.041 5.046 1.070~23.809
ASA分级 -1.659 0.729 5.170 0.023 0.190 0.046~0.795
手术时间 0.063 0.031 4.074 0.044 1.066 1.002~1.133
出血量 0.132 0.058 5.110 0.024 1.141 1.018~1.280
术中体温水平 -4.274 1.613 7.019 0.008 0.014 0.001~0.329
图1 腹腔镜袖状胃切除术术中体温水平预测术后预后的采用受试者工作特征曲线
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