口腔颌面恶性肿瘤术后留置人工气道患者呛咳反射风险预测模型构建  

Construction of Cough Reflex Risk Prediction Model Among Patients with Artificial Airway After Oral and Maxillofacial Malignant Tumor Surgery

作　　者：沈招华 王国栋 陈潇卿 李冬 李慧丽 SHEN Zhaohua;WANG Guodong;CHEN Xiaoqing;LI Dong;LI Huili(Department of Stomatology,The First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Department of Stomatology,The Second Affiliated Hospital of Naval Medical University,Shanghai 200041,China)

机构地区：[1]海军军医大学第一附属医院口腔科,上海200433 [2]海军军医大学第二附属医院口腔科,上海200041

出　　处：《军事护理》2025年第1期77-80,90,共5页MILITARY NURSING

摘　　要：目的调查口腔颌面恶性肿瘤患者术后留置人工气道患者呛咳反射的发生情况和影响因素,并构建风险预测模型。方法2021年8月至2023年8月,采用便利抽样法选取2所三级甲等医院收治的口腔颌面恶性肿瘤术后留置人工气道患者150例为研究对象,采用自制调查问卷对其进行纵向研究,了解其发生呛咳反射的影响因素,构建风险预测模型,并分析COX回归模型对口腔颌面恶性肿瘤患者术后留置人工气道患者发生呛咳反射的预测价值。结果口腔颌面恶性肿瘤患者术后留置人工气道患者呛咳反射发生率为31.33%;吸烟史、术前体位训练、卧位角度、应用舒芬太尼、术前放疗是口腔颌面恶性肿瘤术后留置人工气道患者呛咳反射发生的独立影响因素(均P<0.05);根据多因素COX回归分析,建立预测模型,经验证,曲线下面积(area under curve,AUC)为0.949,具有较好的预测价值。结论吸烟史、术前体位训练、卧位角度等均为口腔颌面恶性肿瘤患者术后留置人工气道患者发生呛咳反射的影响因素,COX回归模型能准确预测呛咳反射发生情况,护理人员可据此制订有效的干预措施。Objective To investigate the occurrence and influencing factors of cough reflex in patients with oral and maxillofacial malignancy who are left with an artificial airway after surgery,and to construct a risk prediction model.Methods The convenience sampling method was used to select 150 patients who underwent oral and maxillofacial malignant tumor surgery and were equipped with artificial airways at two tertiary A hospitals from August 2021 to August 2023 as the study subjects.A longitudinal study was conducted using a self-designed questionnaire to investigate the factors influencing the occurrence of coughing reflex in these patients.Based on the collected data,a risk prediction model was constructed.The predictive value of COX regression model for cough reflex in patients with oral and maxillofacial malignant tumor after operation was analyzed.Results The incidence of cough reflex in these patients was 31.33%.Smoking history,preoperative postural training,angle of prone position,sufentanil application,and preoperative radiotherapy were independent factors influencing the occurrence of cough reflex in patients with oral and maxillofacial malignancies after surgery(all P<0.05).According to the multivariate COX regression analysis,the prediction model was established,and it was verified that the area under curve(AUC)was 0.949,which had a good predictive value.Conclusions Smoking history,preoperative posture training,and angle of prone position are all factors affecting the occurrence of cough reflex in patients with oral and maxilfacial malignancy after surgery.The COX regression model can accurately predict the occurrence of cough reflex,and the nursing staff can formulate effective intervention measures based on it.

关 键 词：口腔颌面恶性肿瘤 术后 呛咳 人工气道 影响因素 风险预测 

分 类 号：R473.78[医药卫生—护理学] R823[医药卫生—临床医学]