游离组织瓣修复口腔颌面部肿瘤术后缺损血管危象的影响因素配对logistic回归分析

Paired logistic regression analysis of influencing factors for vascular crisis after repair of oral and maxillofacial tumors with free tissue flaps

目的探讨口腔颌面部肿瘤切除游离组织瓣移植术后发生血管危象的影响因素。方法对2015—2020年某三甲专科医院头颈肿瘤外科病房完成游离组织瓣移植术且发生血管危象的所有患者进行回顾性分析。从同时期该病房未发生血管危象的患者中,根据手术医生、手术时间、患者性别和年龄进行1∶1配对,收集46个可能的影响因素,采用SPSS 26.0统计软件对数据进行单因素和多因素logistic回归分析。结果共纳入158例患者,其中危象组和配对组各79例,先对各变量进行单因素分析,将单因素分析P<0.2的变量进行配对logistic回归分析,仅术后血钾(P=0.048,OR=3.118,95%CI:1.008~9.641)和术前术后红细胞计数差值(P=0.004,OR=4.53,95%CI:1.609~12.750)有统计学意义。结论术后血钾水平高及手术前后红细胞计数差值大是血管危象的危险因素。

Objective To investigate the influencing factors of vascular crisis after oral and maxillofacial tumor free tissue flap transplantation.Methods A retrospective analysis was performed on all patients who underwent free tissue flap transplantation and developed vascular crisis in the surgical ward of head and neck cancer in a grade A specialized hospital.Forty-six possible influencing factors were collected using 1:1 matching according to surgeons,operation time,sex and age of patients from patients without vascular crisis from 2015-2020 in this ward during the same period.SPSS26.0 statistical software was used for univariate and multivariate logistic regression analyses of the data.Results A total of 158 patients were enrolled,including 79 in the crisis group and 79 in the pairing group.Univariate analysis was performed for each variable.Paired logistic regression analysis showed that only postoperative blood potassium(P =0.048,OR = 3.118,95% CI:1.008-9.641) and preoperative and postoperative red blood cell count differences(P =0.004,OR = 4.53,95% CI:1.609-12.750) were statistically significant.Conclusion High blood potassium levels and red blood cell count differences before and after surgery were risk factors for vascular crisis.