腹腔镜结直肠癌手术术中低体温预警模型的构建与验证OA

Objective To construct and verify the early warning model of the hypothermic risk factors during laparoscopic surgery in the patients with colorectal cancer in order to guide the clinical preventive measures.Methods A total of 475 patients with colorectal cancer undergoing laparoscopic surgery in this hos-pital from January 2020 to December 2021 were selected.Eighty-three patients with hypothermia during sur-gery served as the validation group(n=83)and the other served as the non-hypothermia control group(n=392).The general data in the two groups were collected.The univariate analysis and multivariate analysis were adopted to analyze the risk factors of hypothermia during laparoscopic surgery in the patients with colorectal cancer.Then the early warning model was constructed and its accuracy was verified.Results The incidence rate of hypothermia during surgery in 475 patients with colorectal cancer was 17.47％(83/475).The univari-ate and multivariate logistic regression analysis results showed that the anesthesia time＞3 h,operating room temperature ≤23 ℃,BMI≤24 kg/m2,age＞60 years old,intraoperative fluid infusion volume＞1 000 mL were the independent risk factors for intraoperative hypothermia(P＜0.05).The early warning model:logis-tic(P)=-2.213+2.580X(age)+1.608 X(BMI)+1.460 X(operating room temperature)+1.254 X(anes-thesia time)+1.119X(intraoperative fluid infusion volume).The area under the curve(AUC)of the receiver operating characteristic(ROC)curve was 0.709(95％CI 0.631-0.789).The calibration curve showed that the calibration curve was in good agreement with the actual curve,indicating that the model had good discrimi-nation and good prediction fitting(P＜0.001).The result of Hosmer-lemeshow test was x2=162.181,P＜0.001,indicating that the prediction was more accurate.Conclusion The constructed early warning model has good accuracy and discrimination,which could effectively predict the probability of hypothermia during surgery.