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腹部大手术后发生杓状软骨脱位的危险因素:一项回顾性研究。

Risk factors for the occurrence of arytenoid dislocation after major abdominal surgery: A retrospective study.

作者信息

Chen Mo, Yu Tingting, Cui Xiangyan, Wang Xin

机构信息

Department of Otolaryngology Head and Neck Surgery, The First Hospital of Jilin University, Changchun, Jilin, China.

出版信息

Medicine (Baltimore). 2024 Nov 22;103(47):e40593. doi: 10.1097/MD.0000000000040593.

Abstract

The incidence of arytenoid dislocation in abdominal surgery is relatively high, the cause is unknown, and it has not received sufficient attention. To identify the risk factors of arytenoid dislocation after abdominal surgery, and to establish a clinical prediction model based on relevant clinicopathological characteristics. We retrospectively collected the clinical data of 50 patients with arytenoid dislocation (AD) and 200 patients without AD after abdominal surgery with general anesthetic tracheal intubation in our Hospital from January 2013 to December 2019. General information about the patients was collected. Univariate analysis of the factors was performed, and indicators that were statistically significant were included in multivariate logistic regression analyses to identify the relationship between clinicopathological characteristics and arytenoid dislocation. Meanwhile, a clinical prediction model was established. Multivariate logistic regression analyses showed that age, surgical methods, operative time and gastric tube were dependent predictive factors of AD after abdominal surgery. A clinical prediction model was constructed, and the AUC of the ROC curve was 0.88 (95%CI: 0.83-0.94). The calibration plot shows that the prediction curve was close to the ideal curve. Patients undergoing abdominal surgery with general anesthesia exhibit a significantly higher incidence of AD due to a combination of factors. Clinicopathological features can be used as an independent predictor of risk in patients with AD, and a clinical model has been developed that is a good predictor of AD.

摘要

腹部手术中杓状软骨脱位的发生率相对较高,病因不明,且尚未得到足够重视。旨在识别腹部手术后杓状软骨脱位的危险因素,并基于相关临床病理特征建立临床预测模型。我们回顾性收集了2013年1月至2019年12月在我院接受全身麻醉气管插管腹部手术后发生杓状软骨脱位(AD)的50例患者和未发生AD的200例患者的临床资料。收集患者的一般信息。对各因素进行单因素分析,将具有统计学意义的指标纳入多因素logistic回归分析,以确定临床病理特征与杓状软骨脱位之间的关系。同时,建立临床预测模型。多因素logistic回归分析显示,年龄、手术方式、手术时间和胃管是腹部手术后AD的独立预测因素。构建了临床预测模型,ROC曲线的AUC为0.88(95%CI:0.83 - 0.94)。校准图显示预测曲线接近理想曲线。由于多种因素的综合作用,接受全身麻醉腹部手术的患者AD发生率显著更高。临床病理特征可作为AD患者风险的独立预测指标,且已开发出一种临床模型,对AD具有良好的预测能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b66/11596634/fa1551dbb7c2/medi-103-e40593-g001.jpg

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