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目的:探讨剖宫产手术中寒战的影响因素,为临床预防和治疗剖宫产术中寒战提供依据。方法:采用前瞻性病例对照研究,选择2014年1月—2015年6月行剖宫产术的584例按美国麻醉医师学会(ASA)分级为Ⅰ,Ⅱ级剖宫产孕妇为研究对象,在术前进行问卷调查收集资料。根据剖宫产术中是否发生寒战分为观察组和对照组。应用Epi Data3.0建立数据库,二次平行录入有效数据,使用SPSS19.0进行数据处理和统计分析,比较产妇的人口学基本资料、心理学、社会学等因素对寒战发生的影响。结果:584例患者中发生寒战357例,寒战发生率为61.13%;多因素非条件Logistic回归分析显示,年龄>30岁(OR=2.009,95%CI:1.610~4.863)、紧张(OR=4.304,95%CI:1.635~6.341)、恐惧(OR=5.162,95%CI:2.505~7.040)、夫妻关系不和谐(OR=2.903,95%CI:1.064~4.133)、不了解剖宫产(OR=3.058,95%CI:2.142~6.001)等是剖宫产术中发生寒战的危险因素(OR>1);经产妇(OR=0.611,95%CI:0.240~0.934)是剖宫产术中未发生寒战的保护因素(OR<1)。结论:建立和谐的夫妻关系,同时在术前对产妇(特别是30岁以上的初产妇)进行剖宫产知识宣教和心理疏导,减少紧张和恐惧,可以降低寒战发生率。
Objective: To investigate the influencing factors of chills during cesarean section and to provide basis for clinical prevention and treatment of chills in cesarean section. Methods: A prospective case-control study was conducted. 584 pregnant women undergoing cesarean section from January 2014 to June 2015 were enrolled in this study. The pregnant women underwent cesarean section Ⅰ and Ⅱ according to American College of Anesthesiologists (ASA) Preoperative questionnaires to collect information. According to the occurrence of chills in cesarean section divided into observation group and control group. Epi Data3.0 was used to establish the database, the second parallel access to valid data, the use of SPSS19.0 for data processing and statistical analysis, comparison of demographic basic information, psychology, sociology and other factors on the chills impact. Results: A total of 357 chills and chills were found in 584 patients. The multivariate Logistic regression analysis showed that patients aged> 30 years (OR = 2.009, 95% CI: 1.610-4.863) and stress (OR = 4.304 , 95% CI: 1.635-6.341), fear (OR = 5.162, 95% CI: 2.505-7.0040), and the marital relationship was not harmonious (OR = 2.903,95% CI: 1.064-4.13 3) = 3.058, 95% CI: 2.142 ~ 6.001) were the risk factors of chills (OR> 1) in cesarean section. The maternal (OR = 0.611, 95% CI: 0.240-0.934) No cholera protection factor (OR <1). Conclusion: Establishing a harmonious relationship between husband and wife and preoperatively educating and counseling cesarean section on maternal (especially primiparous patients over the age of 30), reducing tension and fear can reduce the incidence of chills.