在接受全膝关节置换手术的患者中,与术后出现低氧症相关的因素及其预测模型的创建和验证
Yi He1, Yong Chen, Hongjun Zhang
1The Third People's Hospital of Chengdu, Chengdu, Sichuan Province, China.
Medicine
|November 5, 2025
概括
这项研究确定了在全膝关节置换手术后术后低氧症的关键风险因素. 一个经过验证的nomogram预测模型可以帮助临床医生识别高风险患者进行早期干预.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 关键护理医学 关键护理医学
背景情况:
- 手术后的低氧化症是膝关节全关节整形术 (TKA) 后的一个重大并发症.
- 确定预测因素和开发可靠的模型对于患者管理至关重要.
研究的目的:
- 探索与TKA患者术后低氧化症相关的危险因素.
- 构建和验证一个预测模型,用于早期识别处于风险中的个人.
主要方法:
- 来自569名TKA患者的临床数据的回顾性分析.
- 单变量和多变量逻辑回归以确定独立的风险因素.
- 用于可视化的名图构造,使用ROC分析,Hosmer-Lemeshow测试,Bootstrap和10倍交叉验证进行验证.
主要成果:
- 手术后缺氧症的发生率为20.56% (117/569名患者).
- 确定的独立风险因素包括:没有神经阻塞,年龄>65岁,慢性阻塞性肺病,ASA分类>II,以及手术内流体摄入>1500毫升.
- 开发的名图表显示出良好的区分能力,适应效果和临床实用性.
结论:
- 在TKA之后的术后低氧症是多因素的.
- 建立的诺莫格拉姆预测模型是准确的,并且在临床上对高风险TKA患者的早期风险评估和干预有用.
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