妇科手术患者入麻醉恢复室后低氧血症预测模型的构建与验证
Construction and verification of hypoxemia prediction model for gynecological operation patients after entering postanesthesia care unit
黄贻勇 1李婧 2李敏2
作者信息
- 1. 乌鲁木齐市中医医院麻醉科,新疆乌鲁木齐 830000
- 2. 乌鲁木齐市友谊医院麻醉科,新疆乌鲁木齐 830049
- 折叠
摘要
目的 构建并验证妇科手术患者入麻醉恢复室后低氧血症预测模型.方法 选取2019年6月至2023年6月乌鲁木齐市中医医院收治的90例行妇科手术治疗的患者作为回顾性研究的对象.根据术后入麻醉恢复室的观察结果,将患者分为发生低氧血症组和未发生低氧血症组.收集患者的临床资料,并使用单因素及多因素logistic回归进行分析,筛选出影响妇科手术患者术后发生低氧血症的危险因素,构建预测模型并对其进行验证.结果 术后入麻醉恢复室的妇科手术患者中,71例患者未发生低氧血症,19例(21.11％)患者术后发生低氧血症.多因素logistic回归分析结果显示,高龄、高BMI、高血压史、ASA分级Ⅲ级、腹腔镜手术是妇科手术患者入麻醉恢复室后发生低氧血症的危险因素(OR=2.406、2.948、1.931、3.180、1.772,P＜0.05).使用多因素logistic回归分析的结果建立妇科手术患者麻醉恢复室术后发生低氧血症的风险预测列线图模型,Bootstrap法内部验证结果显示,C-index为0.797(95％C/:0.752～0.874),受试者工作特征(ROC)曲线下面积、灵敏度、特异度分别为0.825、80.97％、82.43％.结论 年龄、BMI、高血压史、ASA分级、手术类型均是妇科手术患者麻醉恢复室术后发生低氧血症的独立影响因素,使用以上因素构建的预测模型具有一定的区分度和准确性.
Abstract
Objective To establish and verify the prediction model of hypoxemia in gynecological surgery patients after entering postanesthesia care unit(PACU).Methods Ninety patients who underwent gynecological surgery in Urumqi Hospital of Traditiond Chinese Medicine from June 2019 to June 2023 were selected as the study objects.According to the observation results of the PACU,the patients were divided into the hypoxemia group and the non-hypoxemia group.Clinical data of patients were collected and analyzed by univariate and multivariate logistic regression,in order to screen out the risk factors affecting postoperative hypoxemia in gynecological surgery patients and build a prediction model and verify it.Results Gynecological operation patients admitted to the PACU after surgery,71 patients did not experience hypoxemia,19 patients(21.11％)did.Multivariate logistic regression analysis showed that elder age,high BMI,history of hypertension,ASA Ⅲ grade and laparoscopic surgery were the risk factors for postoperative hypoxemia in gynecological surgery patients after entering PACU(OR=2.406,2.948,1.931,3.180,1.772,P＜0.05).Multivariate logistic regression analysis was used to establish a risk early warning model for postoperative hypoxemia in gynecological operation patients after entering PACU.The internal verification results of Bootstrap method showed that the C-index was 0.797(95％CI:0.752-0.874),the area under receiver operating characteristic(ROC)curve,sensitivity and specificity were 0.825,80.97％and 82.43％,respectively.Conclusion Age,BMI,history of hypertension,ASA grade and surgical method are all influencing factors for postoperative hypoxemia in gynecological surgery patients.The prediction model based on the above factors has a certain degree of differentiation and accuracy.
关键词
妇科手术/麻醉恢复室/术后低氧血症/预测模型/列线图Key words
Gynecological surgery/Postanesthesia care unit/Postoperative hypoxemia/Prediction model/Nomogram引用本文复制引用
出版年
2024
NETL
NSTL
万方数据