摘要
目的 筛选新型冠状病毒感染患者无痛消化内镜诊疗(PGIE)术中低氧血症的危险因素.方法 回顾性收集2022年12月至2023年4月于我院行PGIE的新型冠状病毒感染患者病例资料,根据术中低氧血症发生情况分为低氧血症组(n=201)和非低氧血症组(n=747),采用logistic回归分析法,筛选术中低氧血症的影响因素.结果 2组年龄比率、ASA分级比例、吸烟程度比率、高血压病程比率、PGIE类型比率、实施PGIE时段、诱导前MAP、距离确诊新型冠状病毒感染时间、新型冠状病毒感染分型比率和咳嗽情况比率比较差异有统计学意义(P＜0.05).多因素logistic回归分析结果显示:年龄51～65岁、年龄＞65岁、吸烟程度-轻度、吸烟程度-中重度、新型冠状病毒感染期间相关症状及体征-至PGIE咳嗽未愈、新型冠状病毒感染期间相关症状及体征-至PGIE咳嗽已愈是术中发生低氧血症的独立危险因素;PGIE类型-结肠镜、距离确诊新型冠状病毒感染时间43～56 d、距离确诊新型冠状病毒感染时间57～70 d、距离确诊新型冠状病毒感染时间＞70 d是术中低氧血症的独立保护因素.结论 年龄＞50岁、有吸烟习惯、新型冠状病毒感染期间出现咳嗽是PGIE术中低氧血症的独立危险因素;PGIE类型为结肠镜和距离确诊新型冠状病毒感染时间＞42 d是术中低氧血症的独立保护因素.
Abstract
Objective To identify the risk factors for hypoxemia during painless gastrointestinal en-doscopy(PGIE)in patients with COVID-19.Methods Clinical data of COVID-19 patients who underwent PGIE in our hospital from December 2022 through April 2023 were retrospectively collected.The patients were divided into hypoxemia group(n=201)and non-hypoxemia group(n=747)based on the occurrence of intraoperative hypoxemia.The logistic regression analysis was used to identify the influencing factors for intraoperative hypoxemia.Results There were significant differences in age ratio,American Society of An-esthesiologists Physical Status classification ratio,ratio of smoking degree,ratio of hypertension course,ra-tio of PGIE type,period of implementing PGIE,MAP before induction,time to diagnosis of COVID-19,COVID-19 classification ratio and cough ratio between the two groups(P＜0.05).Multivariate logistic re-gression analysis showed that age 51-65 yr,age＞65 yr,smoking degree-mild,smoking degree-moderate to severe,COVID-19 related signs and symptoms-cough not healed until PGIE,COVID-19-related signs and symptoms-cough healed until PGIE were independent risk factors for intraoperative hypoxemia;the PGIE type-colonoscopy,time to diagnosis of COVID-19 and PGIE 43-56 days,time to diagnosis of COVID-19 and PGIE 57-70 days,and time to diagnosis of COVID-19 and PGIE＞70 days were independent protective factors for intraoperative hypoxemia.Conclusions Age＞50 yr,having smoking habit and cough shown dur-ing COVID-19 are independent risk factors for intraoperative hypoxemia;PGIE type-colonoscopy and time to diagnosis of COVID-19 and PGIE＞42 days are independent protective factors for intraoperative hypoxemia.
基金项目
国家自然科学基金(82172190)
江苏省卫生健康委员会医学科研项目面上项目(M2021105)
扬州市重点实验室培育专项基金(YZ20211148)
"十四五"省医学学科/重点实验室建设单位基金(JSDW20223)
万方数据