影响断指再植术后血管危象发生的高危因素分析及风险预测模型构建  

Analysis of high risk factors affecting the occurrence of vascular crisis after finger replantation and construction of risk prediction model

作　　者：李慧娟 刘艳[1] 刘英[1] 张甜 沈玲 LI Huijuan;LIU Yan;LIU Ying;ZHANG Tian;SHEN Ling(Department of Medical Aesthetics,Wuhan Third Hospital(Wuhan University Affiliated Tongren Hospital),Wuhan 430000,China;不详)

机构地区：[1]武汉市第三医院(武汉大学附属同仁医院)医学美容科,430000 [2]武汉市第四医院骨科

出　　处：《临床外科杂志》2024年第12期1255-1258,共4页Journal of Clinical Surgery

摘　　要：目的 探讨断指再植术后血管危象(VC)的高危因素,并构建相应的风险预测模型。方法 2022年1月~2023年2月进行断指再植术的病人183例,根据是否发生VC分为VC组(22例)与无VC组(161例)。利用单因素分析和多因素logistic回归分析筛选高危因素,并构建相应的风险预测模型。结果 单因素分析结果显示,吸烟史、离断程度、缺血时间、损伤原因、动脉修复和静脉修复等因素与血管危象的发生有关(P<0.05)。多因素logistic回归分析显示,吸烟史、离断程度、缺血时间是血管危象的高危因素(P<0.05)。基于血管危象的高危因素建立断指再植术后发生血管危象的列线图模型,其ROC曲线下面积为0.963,灵敏度为91.7%,特异度为96.0%,具有较好的风险预测能力。结论 吸烟史、离断程度、缺血时间是断指再植术后血管危象的独立危险因素。构建的风险预测模型可以为临床医生提供术后风险评估和预测,有助于制定针对性的治疗方案,降低术后并发症的发生率。Objective To investigate the high risk factors of vascular crisis(VC)after replantation of severed finger,and to construct the corresponding risk prediction model.Methods Data of the cases performed in two hospitals between January 2022 and February 2023 were collected,totaling 183 cases.The patients were divided into VC group(22 cases)and non-VC group(161 cases)according to the occurrence of VC.The risk factors were screened by univariate analysis and multivariate logistic regression analysis,and the corresponding risk prediction model was constructed.Results Univariate analysis showed that smoking history,degree of dissection,ischemic time,cause of injury,arterial repair and venous repair were related to the occurrence of vascular crisis(P<0.05).Multivariate logistic regression analysis showed that smoking history,degree of detachment and ischemic time are the risk factors for vascular crisis(P<0.05).Based on the risk factors of vascular crisis,a line graph model was established for the occurrence of vascular crisis after replantation of severed finger.The area under ROC curve was 0.963,the sensitivity was 91.7%,and the specificity was 96.0%,indicating that this model has a good risk prediction ability.Conclusion Smoking history,degree of amputation and ischemic time were independent risk factors for vascular crisis after finger replantation.The constructed risk prediction model can provide clinicians with postoperative risk assessment and prediction,which is helpful to formulate targeted treatment plans and reduce the incidence of postoperative complications.

关 键 词：断指再植 血管危象 高危因素 风险预测 模型构建 影响因素 

分 类 号：R65[医药卫生—外科学]