呼出气一氧化氮在预测全身麻醉手术患者术后肺部并发症发生的应用价值  

Application value of fractional exhaled nitric oxide in predicting occurrence of postoperative pulmonary complications in patients undergoing general anesthesia

作　　者：贺轲渝 程鹏[1] 薛昀 李飞[1] HE Keyu;CHENG Peng;XUE Yun;LI Fei(Department of Anesthesiology,Fuling Hospital Afiiliated to Chongqing University,Chongqing 408099,China)

机构地区：[1]重庆大学附属涪陵医院麻醉科,408099

出　　处：《重庆医学》2022年第21期3639-3643,共5页Chongqing medicine

基　　金：重庆市科卫联合面上项目(2019MSXM061)。

摘　　要：目的评估术前呼出气中一氧化氮(FeNO)与全身麻醉手术患者术后肺部并发症(PPCs)发生的关系。方法通过对该院诊治的112例择期行全身麻醉手术患者围术期临床数据进行回顾性分析,探索影响PPCs发生的相关因素,采用logistic回归性模型和受试者工作特征曲线(ROC)评估手术前FeNO检测对PPCs的预测价值。结果患者的年龄、是否合并COPD、术前FeNO值、加泰罗尼亚外科患者呼吸风险评估(ARISCAT)分级、麻醉时间、液体出入量均是PPCs发生的相关因素(P<0.05)。变量纳入多因素logistic回归分析,显示术前FeNO值(OR=1.158,P=0.001)在全身麻醉手术患者PPCs发生预测作用中的独立性,其ROC曲线下面积(AUC)为0.835,敏感度62.5%,特异度92.3%。结论术前FeNO值是全身麻醉手术患者PPCs发生的独立预测因子,其在全身麻醉PPCs评估中能发挥重要作用。Objective To assess the relationship between the preoperative fractional exhaled nitric oxide(FeNO)and the occurrence of postoperative pulmonary complications(PPCs)in the patients undergoing general anesthesia surgery.Methods The perioperative clinical data of 112 patients undergoing elective general anesthesia in Fuling Hospital Affiliated to Chongqing University were retrospectively analyzed to explore the relevant factors affecting the occurrence of PPCs.The predictive value of preoperative FeNO testing on PPCs was evaluated by using logistic regression model and receiver operating characteristic(ROC)curve.Results The patients’age,complicating COPD,preoperative FeNO value,ARISCAT grade,duration of anesthesia,liquid in and out quantity were the relevant factors of the PPCs occurrence(P<0.05).The variables above were included in the multivariate logistic regression analysis.The results showed that the independence of preoperative FeNO value(OR=1.158,P=0.001)in predicting the occurrence of PPCs in the patients undergoing general anesthesia surgery,the area under its ROC curve was 0.835,the sensitivity was 62.5%,and the specificity was 92.3%.Conclusion Preoperative FeNO value is an independent predictive factor for the occurrence of PPCs in the patients undergoing general anesthesia surgery,and could play an important role in the assessment of PPC in general anesthesia surgery.

关 键 词：全身麻醉 肺部并发症 术后 呼出气一氧化氮 

分 类 号：R614.2[医药卫生—麻醉学]