无痛消化内镜术中不良反应影响因素分析与预警模型构建研究  

Study on influencing factors and early warning model construction of adverse reactions during painless digestive endoscopy

作　　者：王龙岩 马翠 聂燕 WANG Long-yan;MA Cui;NIE Yan(Department of Gastroenterology Endoscopy,the First Affiliated Hospital of the Air Force Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学第一附属医院消化内科内镜中心,陕西西安710032

出　　处：《创伤与急危重病医学》2024年第4期222-226,共5页Trauma and Critical Care Medicine

摘　　要：目的探讨无痛消化内镜术中患者出现不良反应的影响因素,并构建预警模型以预测不良反应的发生。方法选取自2021年6月至2022年11月于空军军医大学第一附属医院消化内科内镜中心行无痛消化内镜术的326例患者为研究对象,并根据出现不良反应情况将其分为不良反应组(n=37)与非不良反应组(n=289)。收集并比较两组患者的一般资料。利用Logistic回归模型分析影响不良反应的相关因素,并构建指数方程预测模型。采用受试者工作特征(ROC)曲线模型评估预测模型的效能。结果326例行无痛消化内镜术患者中,不良反应发生率为11.3%(37/326)。Logistic回归分析结果表明,年龄>75岁、体质量指数(BMI)>24.0 kg/m^(2)、有慢性阻塞性肺疾病(COPD)史和鼾症史均为无痛消化内镜术中出现不良反应的影响因素(P<0.05)。根据Logistic回归系数拟定建立指数方程,并绘制ROC曲线,指数方程预测无痛消化内镜术中发生不良反应的曲线下面积为0.787,敏感度为75.70%,特异性为69.70%。结论无痛消化内镜术中不良反应的发生与患者年龄、BMI、COPD史和鼾症史密切相关,根据上述指标构建的预测模型对评估手术风险和指导临床决策具有重要意义。Objective To investigate the influencing factors of adverse reactions in patients undergoing painless digestive endoscopy,and establish an early warning model to predict the occurrence of adverse reactions.Methods A total of 126 patients who underwent painless digestive endoscopy at the Gastroenterology Endoscopy Center of the First Affiliated Hospital of Air Force Military Medical University from June 2021 to November 2022 were selected as the study objects,and were divided into adverse reaction group(n=37)and non-adverse reaction group(n=289)according to the occurrence of adverse reactions.General data of the two groups were collected and compared.Logistic regression model was used to analyze the related factors affecting adverse reactions,and an exponential equation prediction model was constructed.The receiver operating characteristic(ROC)curve model was used to evaluate the efficacy of the prediction model.Results Among 326 patients who underwent painless digestive endoscopy,the incidence of adverse reactions was 11.3%(37/326).Logistic regression analysis showed that age>75 years old,body mass index(BMI)>24.0 kg/m 2,history of chronic obstructive pulmonary disease(COPD)and history of snoring were all influential factors for adverse reactions during painless digestive endoscopy(P<0.05).According to the Logistic regression coefficient,an exponential equation was established and the ROC curve was drawn.The exponential equation predicted that the area under the curve of adverse reactions during painless digestive endoscopy was 0.787,the sensitivity was 75.70%,and the specificity was 69.70%.Conclusion The occurrence of adverse reactions during painless digestive endoscopy is closely related to the patient s age,BMI,COPD history and snoring history.The prediction model constructed according to the above indicators is of great significance for evaluating surgical risk and guiding clinical decision-making.

关 键 词：无痛消化内镜术 不良反应 影响因素 

分 类 号：R614[医药卫生—麻醉学]