Abstract:

Objective To explore trend of the core temperature variation，the incidence of perioperative hypothermia and influencing factors during pediatric living-donor liver transplantation，so as to provide a theoretical basis for policies and procedures for prevention and treatment of hypothermia. Methods Cluster sampling method was used to collect the clinical data of 334 pediatric patients who underwent living-donor liver transplantation from November 2017 to December 2023 at a tertiary general hospital in Shanghai. Based on literature review method and expert meeting method，a questionnaire on influencing factors for intraoperative hypothermia during pediatric living-donor liver transplantation was designed and was used for investigation. Univariate analysis and logistic regression analysis were applied to identify the influencing factors. Results During the pediatric living-donor liver transplantation，the core temperature shows the variation trend of “slowly increase-rapidly decrease-recover-stabilization”. The incidence of intraoperative hypothermia is 55.09%. Logistic regression analysis revealed that gender，age in months，body weight，Child-Pugh score，baseline temperature upon admission，duration of surgery，and duration of anesthesia are factors influencing the occurrence of hypothermia during living donor liver transplantation in infants and young children. Conclusion The incidence of hypothermia in pediatric living-donor liver transplantation is high. Perioperative nurses should attach importance to evaluate the influencing factors for hypothermia and develop strategies to minimize the risk of hypothermia in pediatric patients who underwent living-donor liver transplantation at risk.

Key words: Infants and Young Children, Living-Donor Liver Transplantation, Hypothermia, Root Cause Analysis, Pediatric Nursing

摘要：

目的 探讨婴幼儿活体肝移植术中核心体温变化趋势、低体温发生现状及影响因素，为制订婴幼儿活体肝移植术中低体温管理方案提供理论依据。 方法 采用整群抽样法，选取2017年11月—2023年12月在上海市某三级甲等综合医院的334例行活体肝移植术的患儿为调查对象，使用经文献回顾及专家会议讨论后设计的婴幼儿活体肝移植术中低体温影响因素调查表进行调查，采用单因素分析及Logistic回归分析探讨婴幼儿活体肝移植术中低体温发生的影响因素。 结果 婴幼儿活体肝移植术中体温呈现“缓升-速降-回升-平缓”的变化趋势，术中低体温发生率为55.09%。Logistic回归分析结果显示，性别、月龄、体重、儿童终末期肝病模型评分、入室基础体温、手术时间与麻醉时间是婴幼儿活体肝移植术中发生低体温的影响因素。 结论 婴幼儿活体肝移植术中低体温发生率较高，手术室护士应重视识别术中低体温的影响因素，制订有效的预防措施。

关键词: 婴幼儿, 活体肝移植, 低体温, 影响因素分析, 儿科护理学