腹膜炎术后并发急性呼吸窘迫综合征的危险因素分析及预测模型构建  

Risk factor analysis and prediction model construction of acute respiratory distress syndrome after peritonitis

作　　者：吕锋 傅庆洋 孙宁杰[1] LYU Feng;FU Qingyang;SUN Ningjie(Department of Emergency,Yiwu Central Hospital,Yiwu 322110,China;Department of Gastrointestinal Surgery,Yiwu Central Hospital,Yiwu 322110,China)

机构地区：[1]义乌市中心医院急诊科,浙江义乌322110 [2]义乌市中心医院胃肠外科,浙江义乌322110

出　　处：《健康研究》2022年第4期451-454,464,共5页Health Research

摘　　要：目的分析影响腹膜炎术后并发急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的危险因素,构建预测模型,以期为临床早期诊断和干预提供参考。方法回顾性分析90例行手术治疗的腹膜炎患者的临床资料,统计术后72 h发生ARDS的病例数,比较是否发生ARDS患者间的临床资料,分析腹膜炎患者术后并发ARDS的危险因素,并建立预测模型。结果90例行手术治疗的腹膜炎患者中发生ARDS 21例,单因素分析结果显示,ARDS组SOFA评分>6分、输血、休克、去甲肾上腺素剂量>0.1μg/(kg·min)的占比高于非ARDS组,差异均有统计学意义(P<0.05)。多因素分析结果显示,SOFA评分>6分、输血、去甲肾上腺素剂量>0.1μg/(kg·min)、休克是腹膜炎术后并发ARDS的相关因素(P<0.05)。构建模型显示腹膜炎术后并发ARDS的ROC曲线下面积为0.889,预测灵敏度和特异度分别为87.00%、81.00%。结论SOFA评分、输血、休克、去甲肾上腺素剂量可作为临床预测患者腹膜炎术后是否并发ARDS的重要参考依据。Objective To analyze the risk factors affecting acute respiratory distress syndrome(ARDS)after peritonitis,and to construct a prediction model to provide a reference for early clinical diagnosis and intervention.Methods The clinical data of 90 patients with peritonitis who underwent surgical treatment were retrospectively analyzed.The number of cases with ARDS at 72 hours after surgery was counted,and the clinical data between patients with ARDS were compared.The risk factors of postoperative ARDS in patients with peritonitis were analyzed,and a prediction model was established.Results Among 90 peritonitis patients who underwent surgical treatment,21 cases developed ARDS.The results of the univariate analysis showed that the proportions of SOFA score>6 points,blood transfusion,shock,and norepinephrine dose>0.1μg/(kg·min)of the ARDS group were higher than those of the non-ARDS group,and the differences were statistically significant(P<0.05).The constructed model showed that the area under the receiver operating characteristic curve(ROC)of concurrent ARDS after peritonitis was 0.889,with a predictive sensitivity and specificity of 87.00%and 81.00%,respectively.Conclusions SOFA score,blood transfusion,shock,and norepinephrine dose can be used as an important reference for the clinical prediction of postoperative ARDS in patients with peritonitis.

关 键 词：腹膜炎 急性呼吸窘迫综合征 危险因素 预测模型 

分 类 号：R563.8[医药卫生—呼吸系统]