下颌第三磨牙拔除术后出血风险模型的构建  

Study on risk model for postextraction bleeding of mandibular third molars

作　　者：王建荣 孙静 赵树红 尚将 WANG Jian-rong;SUN Jing;ZHAO Shu-hong;SHANG Jiang(Department of Nursing,Yantai Stomatological Hospital.Yantai 264000,Shandong Province,China;Department of Oral and Maxillofacial Surgery,Yantai Stomatological Hospital.Yantai 264000,Shandong Province,China)

机构地区：[1]烟台市口腔医院护理部,山东烟台264000 [2]烟台市口腔医院口腔颌面外科,山东烟台264000

出　　处：《中国口腔颌面外科杂志》2023年第5期479-485,共7页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨下颌第三磨牙拔除术后出血的风险因素并建立预测模型,为临床决策提供参考。方法:收集610例下颌第三磨牙拔除术后患者的病例资料,分析术后出血与患者人口学变量(性别)、牙解剖变量(与[牙合]平面关系、阻生角度)及其他变量(牙周炎、术中麻醉药品、术中翻瓣、术后处理方式、止血材料及方法、术后依从性)的关系。采用SAS 9.4软件包对数据进行统计学分析。结果:610例下颌第三磨牙拔除术后患者的出血发生率为10.33%,63例患者发生出血。多因素logistic回归分析显示,与[牙合]平面关系、阻生角度、术中翻瓣、术后处理方式、术后依从性均为下颌第三磨牙拔除术后发生出血的独立风险因素。用验证组的病例资料验证预测模型,结果显示预测模型区分度较好(AUC=0.916),校准度较高(P=0.605)。结论:与[牙合]平面关系、阻生角度、术中翻瓣、术后处理方式、术后依从性为出血独立风险因素,可作为预测模型的预测因子。PURPOSE:To explore the risk factors of bleeding after mandibular third molar extraction and establish a prediction model to provide reference for clinical decision-making.METHODS:Clinical data of 610 cases of mandibular third molar extraction were collected for the study.Association of postextraction bleeding with the patient demographic variables(gender),tooth variables(position,impacted angle)and other variables(periodontitis,intraoperative anesthetic drugs,flap,postoperative treatment,hemostatic materials,patient compliance).SAS 9.4 software package was used to analyze the data.RESULTS:The incidence of postextraction bleeding was 10.33%in 610 patients after mandibular third molars extraction,and 63 patients had postextraction bleeding.Multivariate logistic regression analysis showed that the position,impacted angle,flap,postoperative treatment,patient compliance were independent risk factors for postextraction bleeding of mandibular third molars.The results showed that the prediction model had good differential validity(AUC=0.916),high calibration degree(P=0.605),and certain clinical application value.CONCLUSIONS:The position,impacted angle,flap,postoperative treatment and patient compliance are not only risk factors for postextraction bleeding,but also predictive factors for predictive models.

关 键 词：第三磨牙 智牙 牙拔除术 出血 风险因素 预测模型 

分 类 号：R782.1[医药卫生—口腔医学]