气管插管全身麻醉患者苏醒期躁动风险预测模型的构建

Construction of Risk Prediction Model of Emergence Agitation in Patients with Tracheal Intubation under General Anesthesia

目的:通过相关数据分析探讨气管插管全身麻醉患者苏醒期躁动(EA)的危险因素并建立预测模型。方法:回顾性选取2021年12月至2022年7月惠州市第一妇幼保健院收治的200例手术患者资料,全部患者均采用气管插管全身麻醉,将进入术后恢复室后发生EA的49例患者纳入EA组,将未发生EA的151例患者纳入非苏醒期躁动(NEA)组,在此基础上分析相关数据,建立预测模型并评价效能。结果:单因素分析结果显示,年龄、术前置管宣教、入术后恢复室后有寒颤、疼痛评估量表(FLACC)评分、应用右美托咪定为气管插管全身麻醉患者EA发生的影响因素(P<0.05);多因素logistic回归分析结果显示,患者年龄越大、入术后恢复室后有寒颤、疼痛程度越高为气管插管全身麻醉患者EA发生的危险因素(OR> 1,P<0.05);术前置管宣教、应用右美托咪为EA发生的保护因素(OR <1,P<0.05);受试者工作特征(ROC)曲线分析结果显示,预测模型的曲线下面积(AUC)=0.950,95%CI为(0.907,0.992),P<0.001,灵敏度为93.878%,特异度为96.026%。结论:患者年龄大、入术后恢复室后有寒颤、疼痛程度高会增加气管插管全身麻醉患者EA发生的风险,而术前置管宣教、应用右美托咪可降低风险,以此为基础建立的预测模型对全身麻醉患者发生EA的风险预测效能较高。

Objective To explore the risk factors of emergence agitation(EA)during recovery period in patients undergoing general anesthesia through tracheal intubation and establish a predictive model by analyzing relevant data.Methods The data of 200 surgical patients admitted to Huizhou First Maternal and Child Health Care Hospital from December 2021 to July 2022 were retrospectively selected.All patients were treated with general anesthesia through tracheal intubation.49 patients with general anesthesia after entering the postoperative recovery room were included in the EA group,and 151 patients without EA were included in the non emergence agitation(NEA)group.Based on this,relevant data were analyzed,predictive models were established,and effectiveness was evaluated.Results The results of univariate analysis showed that age,preoperative education,shivering after admission to the recovery room,pain FLACC score,and use of dexmedetomidine were the influencing factors for the occurrence of EA in patients undergoing tracheal intubation and general anesthesia(P<0.05);The results of multivariate logistic regression analysis showed that the older the patient,the higher the degree of pain and shivering after entering the recovery room after surgery were the risk factors for EA in patients undergoing tracheal intubation general anesthesia(OR>1,P<0.05);Preoperative tube education and dexamethasone use were protective factors for EA(OR<1,P<0.05);The receiver operating characteristic curve(ROC)analysis results showed that the area under curve(AUC)of the prediction model was 0.950,with a 95%CI of(0.907,0.992),P<0.001,a sensitivity of 93.878%,and a specificity of 96.026%.Conclusion Elderly patients,shivering after entering the recovery room after surgery,and high degree of pain may increase the risk of EA in patients undergoing tracheal intubation and general anesthesia,while preoperative tube education and use of dexamethasone can reduce the risk.The prediction model established based on these has a high predictive effect on the risk of EA in patients undergoing general anesthesia.