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口腔颌面部恶性肿瘤患者术后发生谵妄的影响因素分析

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目的 探讨口腔颌面部恶性肿瘤(OMM)患者术后发生谵妄的影响因素.方法 根据术后是否发生谵妄将106例OMM患者分为谵妄组(n=24)和对照组(n=82).收集并比较两组患者的临床资料,采用二元Logis-tic 回归模型分析 OMM 患者术后发 生谵妄的影响 因素.构建OMM患者术后谵妄预测模型列线图,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),验证模型的准确性.结果 谵妄组中有酗酒史的患者比例明显高于对照组,谵妄组患者收缩压(SBP)明显低于对照组,差异均有统计学意义(P<0.01).单因素和多因素Lo-gistic 回归分析结果显示,高 SBP 是 OMM 患者术后发生谵妄的独立保护因素(P<0.05),酗酒史是OMM患者术后发生谵妄的独立危险因素(P<0.05).预测模型的AUC为0.723(95%CI:0.614~0.832).结论 高SBP是OMM患者术后发生谵妄的保护因素,酗酒史是OMM患者术后发生谵妄的危险因素.医务工作者应针对上述影响因素及早干预,从而降低术后谵妄的发生风险.
Analysis of influencing factors of postoperative delirium in patients with oral and maxillofacial malignancy
Objective To explore the influencing factors of postoperative delirium in patients with oral and maxillofa-cial malignancy(OMM).Method According to whether delirium occurred after operation,106 OMM patients were di-vided into delirium group(n=24)and control group(n=82).The clinical data of the two groups were collected and com-pared,and the influencing factors of postoperative delirium in OMM patients were analyzed by binary Logistic regression model.The postoperative delirium prediction model nomogram of OMM patients was constructed,the receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to verify the accuracy of the model.Result The proportion of patients with history of alcoholism in delirium group was significantly higher than that in control group,and the SBP in delirium group was significantly lower than that in control group,and the differences were statistically significant(P<0.01).Univariate and multivariate Logistic regression analysis showed that high SBP was an independent protective factor for postoperative delirium in OMM patients(P<0.05),and history of alcoholism was an independent risk factor for postoperative delirium in OMM patients(P<0.05).The AUC of the prediction model was 0.723(95%CI:0.614-0.832).Conclusion High SBP is a protective factor for postoperative delirium in OMM patients,and history of alcoholism is a risk factor for postoperative delirium in OMM patients.According to the above factors,medical workers should intervene early to reduce the risk of postoperative delirium.

oral and maxillofacial malignancydeliriuminfluencing factorsystolic blood pressurehistory of alco-holism

赵景杰

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滨州市第二人民医院口腔科,山东 滨州 256800

口腔颌面部恶性肿瘤 谵妄 影响因素 收缩压 酗酒史

2024

癌症进展
中国医学科学院,北京协和医学院

癌症进展

影响因子:1.004
ISSN:1672-1535
年,卷(期):2024.22(9)