幕上深部肿瘤患者术后脱氧失败的影响因素及列线图模型的构建  

Influencing factors of failed oxygen therapy weaning in patients with supratentorial deep tumor after general anesthesia

作　　者：齐良 刘雪娇 朱静文 李鹏[1] 陈亚兰 张安琪[1] 杜文文 QI Liang;LIU Xuejiao;ZHU Jingwen;LI Peng;CHEN Yalan;ZHANG Anqi;DU Wenwen(Department of Anesthesiology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;不详)

机构地区：[1]温州医科大学附属第一医院麻醉科,325000 [2]浙江省人民医院(杭州医学院附属人民医院)麻醉科

出　　处：《浙江医学》2024年第16期1706-1710,1718,共6页Zhejiang Medical Journal

基　　金：温州市基础性公益科研项目(Y2023969);浙江省自然科学基金项目(LQ24H310013)。

摘　　要：目的探讨幕上深部肿瘤患者全身麻醉术后脱氧失败的影响因素,构建列线图模型并对其进行验证。方法回顾性选择2016年1月至2021年12月在温州医科大学附属第一医院择期全身麻醉下行幕上深部肿瘤切除手术的患者364例,根据麻醉复苏室(PACU)是否脱氧成功,将患者分为脱氧失败组105例和脱氧成功组259例。收集两组患者的一般资料、术中情况及两组患者的麻醉医生工作情况。采用简单随机分组法按8∶2将患者分为训练集291例和验证集73例。对训练集采用单因素和多因素logistic回归分析PACU脱氧失败的危险因素,并构建列线图模型,评估预测效能。结果多因素logistic回归分析发现患者年龄、BMI、地佐辛、输血、麻醉医生交接班是术后脱氧失败的独立危险因素(均P<0.05)。以此构建的列线图预测模型在验证集中的AUC为0.831,灵敏度为0.946,特异度为0.444。结论基于logistic回归分析建立的列线图模型预测效能较好,有助于医务人员预测和预防幕上深部肿瘤患者全身麻醉术后脱氧失败。Objective To explore the influencing factors of failed oxygen therapy weaning in patients with supratentorial deep tumor after general anesthesia,and construct a nomogram prediction model.Methods Clinical data of 364 patients with supratentorial deep tumor undergoing surgical resection under general anesthesia from January 2016 to December 2021 in the First Affiliated Hospital of Wenzhou Medical University were retrospectively analyzed,including 105 cases who failed oxygen therapy weaning after general anesthesia and 259 cases with successful weaning.Study subjects were randomly divided into training set(n=291)and validation set(n=73)(8∶2).Univariate and multivariate logistic regression was using to analysis the influencing factors for failed weaning from supplemental oxygen therapy after general anesthesia.Results Multivariate logistic regression analysis showed that age,BMI,dezocine,transfusion and anesthesiologist handovers during operation were independent predictors of failed weaning from supplemental oxygen therapy(all P<0.05).Based on the risk factors,a nomogram prediction model was developed,the AUC of the model in the validation set was 0.831,the sensitivity and specificity was 0.946 and 0.444.Conclusion The nomogram model based on logistic regression analysis has good predictive ability,which may be used to predict and prevent failed weaning from supplemental oxygen therapy after general anesthesia in patients undergoing supratentorial deep tumor resection.

关 键 词：幕上深部肿瘤 低氧血症 影响因素 列线图 

分 类 号：R739.4[医药卫生—肿瘤]