先天性心脏病患儿围术期呼吸系统不良事件预测模型的构建  

Construction of a Prediction Model for Perioperative Adverse Events of Respiratory System in Children with Congenital Heart Disease

作　　者：钟惠真 邱宏[1] 章征兵[1] 李斯斯[1] 张盛[1] 朱玉凤[1] 余雯 ZHONG Huizhen;QIU Hong;ZHANG Zhengbing(Operating Room,Jiangxi Provincial Children’s Hospital,Nanchang City,Jiangxi Province 330000)

机构地区：[1]江西省儿童医院手术室,江西省南昌市330000

出　　处：《医学理论与实践》2022年第23期3981-3984,共4页The Journal of Medical Theory and Practice

基　　金：江西省卫生健康委科技计划(SKJP220225298)。

摘　　要：目的:分析先天性心脏病患儿围术期呼吸系统不良事件(PRAEs)的影响因素并构建预测模型。方法:选取2021年6月—2022年1月于我院治疗的200例先天性心脏病患儿作为研究对象,根据是否发生围术期呼吸系统不良事件分为发生组与未发生组。所有先天性心脏病患儿均进行手术治疗,收集先天性心脏病患儿的一般资料,单因素分析先天性心脏病患儿围术期发生PRAEs的潜在因素,多因素分析确定先天性心脏病患儿围术期发生PRAEs的影响因素,并构建预测模型,采用ROC曲线下面积验证模型的区分度。结果:年龄、手术时间、IL-8水平、CRP水平、是否肥胖、是否被动吸烟、中性粒细胞计数、术后疼痛程度、气道发育是否异常是先天性心脏病患儿围术期呼吸系统不良事件的独立危险因素(P<0.05)。预测模型公式为ln(P/1-P)=(-13.172)-0.469×年龄+0.094×手术时间-0.294×IL-8水平+0.615×CRP水平-3.400×是否肥胖-3.441×是否被动吸烟+2.939×中性粒细胞计数-4.415×术后疼痛程度-3.361×气道发育是否异常。ROC分析结果显示该模型的曲线下面积为0.976,最佳截断值为1.500,灵敏度为98.2%,特异性为97.1%。结论:本次构建的先天性心脏病患儿围术期呼吸系统不良事件预测模型具有良好的预测价值,可为先天性心脏病患儿围术期的治疗提供参考。Objective:To analyze the influencing factors of perioperative respiratory adverse events(PRAEs)in children with congenital heart disease and build a predictive model.Methods:A total of 200 children with congenital heart disease who were treated in our hospital from June 2021 to January 2022 were selected as the research objects,and they were divided into the occurrence group and the non-occurrence group according to whether there were perioperative adverse events of the respiratory system.All children with congenital heart disease were treated with surgery.The general data of children with congenital heart disease were collected,and the potential factors of PRAEs in the perioperative period of children with congenital heart disease were analyzed by univariate analysis.Influencing factors of PRAEs in children during perioperative period,and constructing a predictive model.The discriminative degree of the model was verified by the area under the ROC curve.Results:Age,operation time,IL-8 level,CRP level,obesity,passive smoking,neutrophil count,postoperative pain degree,and abnormal airway development were associated with poor perioperative respiratory system in children with congenital heart disease.Independent risk factors for events(P<0.05).The prediction model formula is ln(P/1-P)=(-13.172)-0.469×age+0.094×operation time-0.294×IL-8 level+0.615×CRP level-3.400×obesity-3.441×passive smoking+2.939×neutrophil count-4.415×postoperative pain degree-3.361×whether airway development is abnormal.The results of ROC analysis showed that the area under the curve of this model was 0.976,the best cut-off value was 1.500,the sensitivity was 98.2%,and the specificity was 97.1%.Conclusion:The perioperative respiratory adverse event prediction model for children with congenital heart disease constructed this time has good predictive value,and can provide a reference for the perioperative treatment of children with congenital heart disease.

关 键 词：先天性心脏病 围术期 呼吸系统不良事件 预测模型 

分 类 号：R725.4[医药卫生—儿科]