牙髓炎患者根管治疗期间急症的预测模型构建与验证  

Construction and Validation of a Predictive Model for Acute Emergencies During Root Canal Treatment in Patients with Pulpitis

作　　者：董刚[1] DONG Gang(Department of Stomatology,Yuebei People’s Hospital,Shaoguan 512026,China)

机构地区：[1]广东省粤北人民医院口腔科,广东韶关512026

出　　处：《反射疗法与康复医学》2025年第7期78-81,93,共5页Reflexology And Rehabilitation Medicine

基　　金：韶关市卫生健康科研项目(KY-2022-095)。

摘　　要：目的探讨牙髓炎患者根管治疗期间急症(EIAE)的预测模型构建与验证。方法回顾性分析2023年1—12月广东省粤北人民收治的200例牙髓炎患者的临床资料。根据是否发生EIAE分为EIAE组(n=55)和非EIAE组(n=145),统计两组患者的一般资料,并进行单因素分析与Logistic回归分析以明确牙髓炎患者出现EIAE的危险因素,并使用Logistic回归模型构建EIAE发生的预测模型,另选取同期60例牙髓炎患者为验证组进行外部验证。结果200例牙髓炎患者55例出现EIAE,发生率为27.50%(55/200)。单因素分析结果显示,两组心理状况、冲洗总药量、根充次数、根充情况、治疗前是否有窦道与牙髓炎患者出现EIAE有关,组间差异有统计学意义(P<0.05)。Logistic回归分析结果显示,有焦虑紧张情绪、冲洗总药量≤2 mL、根充次数多次、根充情况超充、治疗前无窦道是影响牙髓炎患者出现EIAE的高危险因素(P<0.05且OR>1)。基于以上5个独立危险因素构建相应的风险预测,EIAE预测模型的受试者工作曲线下面积为0.726,>0.70,有一定预测价值;Hosmer-Lemeshow拟合优度检验χ^(2)=0.895,P=0.517,P>0.05,拟合度较好,预测价值高。结论牙髓炎患者EIAE预测模型具有良好的预测价值,其危险因素为有焦虑紧张情绪、冲洗总药量≤2 mL、根充次数多次、根充情况超充、治疗前无窦道,临床需高度重视。Objective To explore the construction and validation of a predictive model for acute emergencies during root canal treatment(EIAE)in patients with pulpitis.Methods The clinical data of 200 patients with pulpitis admitted to Yuebei People’s Hospital in Guangdong Province from January to December 2023 were retrospectively analyzed.According to whether EIAE occurred or not,the patients were divided into the EIAE group(n=55)and the non-EIAE group(n=145).The general data of the patients in the two groups were statistically analyzed.Univariate analysis and Logistic regression analysis were carried out to identify the risk factors for EIAE in patients with pulpitis.A Logistic regression model was used to construct a predictive model for the occurrence of EIAE.Another 60 patients with pulpitis in the same period were selected as the validation group for external validation.Results Among the 200 patients with pulpitis,55 cases had EIAE,with an incidence rate of 27.50%(55/200).The results of univariate analysis showed that psychological status,total amount of irrigating solution,number of root canal filling,root canal filling condition,and the presence or absence of a sinus tract before treatment were related to EIAE in patients with pulpitis,and there were statistically significant differences between the two groups(P<0.05).The results of the Logistic regression analysis showed that anxious and nervous emotions,a total amount of irrigating solution≤2 mL,multiple root canal filling times,overfilling in root canal filling,and the absence of a sinus tract before treatment were high-risk factors affecting the occurrence of EIAE in patients with pulpitis(P<0.05 and OR>1).Based on the above five independent risk factors,a corresponding risk prediction was constructed.The area under the receiver operating characteristic curve of the EIAE predictive model was 0.726,which was>0.70,indicating a certain predictive value;the Hosmer-Lemeshow goodness-of-fit test showedχ^(2)=0.895,P=0.517,P>0.05,suggesting a good fit and high pred

关 键 词：牙髓炎 根管治疗期间急症 影响因素 预测模型 

分 类 号：R781.3[医药卫生—口腔医学]