经胸腔镜心脏瓣膜手术术后低氧血症风险预测模型的建立
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v8i2.18881
Abstract
目的：探讨经胸腔镜心脏瓣膜术后中重度低氧血症的危险因素及预防策略，并构建风险预测模型。方法：回顾性分析2023年1月至2023年12月在我院经胸腔镜行心脏瓣膜手术治疗的患者，借助单因素及多因素Logistic回归分析方法筛选中重度低氧血症患者的相关危险因素并构建风险预测模型。结果：本次研究共216例行经胸腔镜心脏瓣膜手术患者，其中术后中重度低氧血症患者共65（30.09%）例。两组间性别、体质指数（BMI）、手术时长、谷草转氨酶（AST）、谷丙转氨酶（ALT）、肌酸激酶同工酶（CK-MB）的基线信息差异有统计学意义（P<0.05）。单因素分析显示BMI（OR=1.18，95%CI 1.03 ~ 1.36），体外循环时间（OR=1.01，95%CI 1.01 ~ 1.01），手术时间（OR=1.01，95%CI 1.01 ~ 1.01），ALT（OR=1.02，95%CI 1.01 ~ 1.04），降钙素原（PCT）（OR=1.02，95%CI 1.01 ~ 1.04）与经胸腔镜心脏瓣膜手术术后低氧血症有关。多因素logistic回归分析显示，BMI、PCT及手术时间为经胸腔镜瓣膜术后患者中重度低氧血症独立危险因素。基于上述因素建立的列线图模型，该模型预测术后中重度低氧患者的AUC值为0.71（95% CI：0.62-0.80）。结论：BMI增加以及手术时间延长均为经胸腔镜瓣膜术后患者中重度低氧血症的独立危险因素，基于上述因素构建的预测模型能定量、简便地评估经胸腔镜心脏瓣膜术后出现中重度低氧血症的风险。
Keywords
心脏术后；低氧血症；风险因素；预测模型
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[9] Song XC, Nie S, Xiao JL, et al. Risk factors and long-term prognosis for postoperative hypoxemia in patients with acute type A aortic dissection: A retrospective observational study. Medicine (Baltimore). 2022. 101(50): e32337.
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