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

内容摘要

To investigate the effect of intraoperative hypothermia on short-term prognosis in neonates with necrotizing enterocolitis (NEC) undergoing surgery. 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 (&#x2265;36.0&#x2103;, n=49), a mild hypothermia group (35.0-35.9&#x2103;, n=73), a moderate hypothermia group (34.0-34.9&#x2103;, n=20), and a severe hypothermia group (<34.0&#x2103;, n=8). Postoperative outcomes were analyzed across groups. 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). 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. &#x76ee;&#x7684;: &#x63a2;&#x7a76;&#x65b0;&#x751f;&#x513f;&#x574f;&#x6b7b;&#x6027;&#x5c0f;&#x80a0;&#x7ed3;&#x80a0;&#x708e;&#xff08;neonatal necrotizing enterocolitis, NEC&#xff09;&#x672f;&#x4e2d;&#x4f4e;&#x4f53;&#x6e29;&#x5bf9;&#x8fd1;&#x671f;&#x9884;&#x540e;&#x7684;&#x5f71;&#x54cd;&#x3002;&#x65b9;&#x6cd5;: &#x56de;&#x987e;&#x6027;&#x6536;&#x96c6;2017&#x5e74;6&#x6708;&#x2014;2023&#x5e74;8&#x6708;&#x91cd;&#x5e86;&#x533b;&#x79d1;&#x5927;&#x5b66;&#x9644;&#x5c5e;&#x513f;&#x7ae5;&#x533b;&#x9662;150&#x4f8b;NEC&#x624b;&#x672f;&#x60a3;&#x513f;&#x7684;&#x8d44;&#x6599;&#x3002;&#x6309;&#x672f;&#x4e2d;&#x6700;&#x4f4e;&#x4f53;&#x6e29;&#x5206;&#x4e3a;&#x6b63;&#x5e38;&#x4f53;&#x6e29;&#x7ec4;&#xff08;&#x2265;36.0&#x2103;&#xff0c;49&#x4f8b;&#xff09;&#x3001;&#x8f7b;&#x5ea6;&#x4f4e;&#x4f53;&#x6e29;&#x7ec4;&#xff08;35.0~35.9&#x2103;&#xff0c;73&#x4f8b;&#xff09;&#x3001;&#x4e2d;&#x5ea6;&#x4f4e;&#x4f53;&#x6e29;&#x7ec4;&#xff08;34.0~34.9&#x2103;&#xff0c;20&#x4f8b;&#xff09;&#x548c;&#x91cd;&#x5ea6;&#x4f4e;&#x4f53;&#x6e29;&#x7ec4;&#xff08;<34.0&#x2103;&#xff0c;8&#x4f8b;&#xff09;&#xff0c;&#x5206;&#x6790;&#x4f4e;&#x4f53;&#x6e29;&#x5bf9;&#x9884;&#x540e;&#x7684;&#x5f71;&#x54cd;&#x3002;&#x7ed3;&#x679c;: 150&#x4f8b;&#x60a3;&#x513f;&#x4e2d;&#xff0c;101&#x4f8b;&#xff08;67.3%&#xff09;&#x53d1;&#x751f;&#x672f;&#x4e2d;&#x4f4e;&#x4f53;&#x6e29;&#x3002;&#x8f7b;&#x5ea6;&#x4f4e;&#x4f53;&#x6e29;&#x663e;&#x8457;&#x589e;&#x52a0;&#x4e86;&#x672f;&#x540e;&#x51dd;&#x8840;&#x529f;&#x80fd;&#x969c;&#x788d;&#x7684;&#x53d1;&#x751f;&#x98ce;&#x9669;&#xff08;OR=2.170&#xff0c;95%CI:1.035~4.552&#xff0c;P<0.05&#xff09;&#x3002;&#x8f7b;&#x5ea6;&#x4f4e;&#x4f53;&#x6e29;&#xff08;B=12.250&#xff0c;95%CI:1.176~23.324&#xff0c;P<0.05&#xff09;&#x548c;&#x91cd;&#x5ea6;&#x4f4e;&#x4f53;&#x6e29;&#xff08;B=24.510&#xff0c;95%CI:1.645~47.376&#xff0c;P<0.05&#xff09;&#x5747;&#x663e;&#x8457;&#x5ef6;&#x957f;&#x4e86;&#x672f;&#x540e;&#x4f4f;&#x9662;&#x65f6;&#x957f;&#xff0c;&#x800c;&#x4e2d;&#x5ea6;&#x4f4e;&#x4f53;&#x6e29;&#x663e;&#x8457;&#x589e;&#x52a0;&#x4e86;&#x4e2d;&#x5fc3;&#x9759;&#x8109;&#x7f6e;&#x7ba1;&#x65f6;&#x957f;&#xff08;B=11.388&#xff0c;95%CI:1.625~21.15&#xff0c;P<0.05&#xff09;&#x3002;&#x7ed3;&#x8bba;: NEC&#x624b;&#x672f;&#x60a3;&#x513f;&#x672f;&#x4e2d;&#x4f4e;&#x4f53;&#x6e29;&#x53d1;&#x751f;&#x7387;&#x9ad8;&#xff0c;&#x4e14;&#x4e0d;&#x540c;&#x7a0b;&#x5ea6;&#x4f4e;&#x4f53;&#x6e29;&#x5bf9;&#x8fd1;&#x671f;&#x9884;&#x540e;&#x7684;&#x5f71;&#x54cd;&#x5b58;&#x5728;&#x5dee;&#x5f02;&#x3002;&#x4e34;&#x5e8a;&#x9700;&#x91cd;&#x89c6;&#x672f;&#x4e2d;&#x4f53;&#x6e29;&#x7ba1;&#x7406;&#xff0c;&#x91c7;&#x53d6;&#x4e3b;&#x52a8;&#x4fdd;&#x6e29;&#x63aa;&#x65bd;&#x6539;&#x5584;&#x9884;&#x540e;&#x3002;.