麻醉恢复室低氧血症预测模型的建立与校验  

Development and validation of the predictive model for hypoxemia in postanesthesia care unit

作　　者：刘熠 张毅[1] 唐永忠[2] 黄东[2] 欧阳文[2] 阎雪彬[2] LIU Yi;ZHANG Yi;TANG Yongzhong;HUANG Dong;OUYANG Wen;YAN Xuebin(Xiangya School of Medicine,Central South University,Changsha 040000,China)

机构地区：[1]中南大学湘雅三医院,长沙市040000 [2]中南大学湘雅三医院麻醉科

出　　处：《临床麻醉学杂志》2021年第1期55-58,共4页Journal of Clinical Anesthesiology

摘　　要：目的探讨影响麻醉后监测治疗室(PACU)低氧血症发生的关键因素,以期建立预测PACU低氧血症发生的模型,为临床预测PACU低氧血症发生的风险提供帮助。方法选择中南大学湘雅三医院2014年1月至2015年8月收入PACU的患者,应用二元Logistics回归筛选PACU低氧血症的独立危险因素,完成模型的初步建立,并以2015年9月至2016年3月收入PACU的患者进行模型校验。结果最终纳入建立模型组497例,检验组107例,分析自变量20个。Logistics回归示:年龄增加、高BMI、俯卧位及手术中应用灌洗液为PACU低氧血症的独立危险因素(P<0.05)。根据上述独立危险因素建立PACU低氧血症预测模型。模型通过Hosmer-Lemeshow检验,受试者工作特征(ROC)曲线下面积为0.775,结果显示PACU低氧血症预测模型效能良好,校验通过。结论本研究建立的PACU低氧血症预测模型能够较好地预测PACU低氧血症的发生风险,预测效能良好。Objective To explore the risk factors of hypoxemia in postanesthesia care unit(PACU),and establish the predictive model for hypoxemia in PACU,which could make significances in clinical research.Methods The clinical data from January 2014 to August 2015 was collected in the Third Xiangya Hospital of Central South University.Independent risk factors of hypoxemia in PACU by the binary Logistics regression were screened out and the primary predictive model was established.A separate cohort of patients in PACU from September 2015 to March 2016 was enrolled to validate the predictive model.Results There were 497 patients and 20 variables were enrolled in the binary Logistics regression and 107 patients were validated by the primary predictive model.Logistics regression showed that age,BMI,prone position,and application of irrigating solution were independent risk factors of hypoxemia in PACU(P<0.05).The risk predictive model of hypoxemia in PACU was established according to those factors.The model was validated by Hosmer-Lemeshow test and the area under the curve of receiver operating characteristic(ROC)was 0.775,so the predictive model for hypoxemia in PACU tested well.Conclusion The risk predictive modele stablished in our study can predict the risk of hypoxemia in PACU well and have good efficacy.

关 键 词：麻醉后监测治疗室 低氧血症 预测模型 

分 类 号：R614[医药卫生—麻醉学]