妇科机器人手术术后恢复时间的预测模型建立  

Prediction model of recovery time after gynecological robotic surgical procedures

作　　者：刘熠 唐永忠 全承炫[3] 黄东[3] 欧阳文[3] 阎雪彬[3] Liu Yi;Tang Yongzhong;Quan Chengxuan;Huang Dong;Ouyang Wen;Yan Xuebin(Department of Anesthesiology,the First Hospital of Changsha,Changsha 410005,China;Hunan Province Key Laboratory of Brain Homeostasis,Changsha 410013,China;Department of Anesthesiology,The Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]长沙市第一医院麻醉科,410005 [2]脑稳态调控湖南省重点实验室,长沙410013 [3]中南大学湘雅三医院麻醉科,长沙410013

出　　处：《中国医师杂志》2021年第12期1805-1809,共5页Journal of Chinese Physician

基　　金：国家重点研发计划(2018YFC2001800);湖南省卫生健康委科研计划项目(20201802)。

摘　　要：目的为了临床精确评估妇科机器人手术的术后康复,探索建立一种评估妇科机器人手术PACU拔管时间和住院时间的预测模型。方法回顾性分析2015年10月至2017年5月于中南大学湘雅三医院行妇科机器人手术患者的临床资料,进行数据筛选,从PACU拔管时间和术后住院时间两方面评估患者术后恢复情况,应用二元logistic回归筛选出影响PACU拔管时间及术后住院时间的因素,初步建立预测模型并校验。结果最终纳入研究的患者456例,综合30个变量,初步建立了评估妇科机器人手术术后恢复的预测模型,其中患者年龄、术中顺势阿曲库铵用量、咪达唑仑用量是影响PACU拔管时间的独立危险因素(均P<0.05),患者ASA分级、术中咪达唑仑用量、术中出血量、手术时间是影响术后住院时间的独立危险因素(均P<0.05)。模型均通过Hosmer-Lemeshow检验(均P>0.05);ROC曲线下面积分别为0.647和0.806。结论初步成功建立了妇科机器人手术患者PACU拔管时间和术后住院时间的预测模型。Objective In order to accurately evaluate the postoperative rehabilitation of gynecological robotic surgery,a prediction model for evaluating postanesthesia care unit(PACU)extubation time and hospital stay in gynecological robotic surgery was established.Methods The clinical data of gynecological patients who underwent robotic surgery in Xiangya Third Hospital of Central South University from October 2015 to May 2017 were retrospectively analyzed,and the data were screened to evaluate the postoperative recovery of patients from two aspects:PACU extubation time and postoperative hospital stay.Binary logistic regression was used to screen out the factors affecting PACU extubation time and postoperative hospital stay,and the prediction model was preliminarily established and verified.Results Finally,there were 456 patients and 30 variables analyzed in the binary logistics regression.According to these variables,the prediction model of the postoperative recovery evaluation after gynecological robotic surgical procedures was established.Among them,age,intraoperative amount of atracurium and midazolam were independent risk factors affecting PACU extubation time(all P<0.05).American Society of Anesthesiologists(ASA)grade,intraoperative amount of midazolam,intraoperative bleeding and operation time were independent risk factors affecting postoperative hospital stay(all P<0.05).All models passed Hosmer lemeshow test(all P>0.05);The areas under the receiver operating characteristic curve(ROC)were 0.647 and 0.806,respectively.Conclusions The prediction model of PACU extubation time and the postoperative hospitalization time has been established.

关 键 词：妇科外科手术 机器人外科手术 插管法 气管内 住院时间 模型 统计学 

分 类 号：R713[医药卫生—妇产科学]