脑卒中恢复期气管切开患者拔管相关因素分析

Analysis of factors related to extubation in convalescentpatients with tracheotomy after stroke

目的:探讨脑卒中恢复期气管切开患者临床特点及影响拔管的相关因素。方法:回顾性分析2015年至2023年在南部战区总医院高压氧康复科住院的72例脑卒中后气管切开患者的病例资料,使用二元Logistic回归方法对可能影响拔管的相关因素进行分析。结果:单因素分析结果显示年龄、脑卒中类型、入院时NHISS评分、出院时NHISS评分、出院时意识状态与拔管相关相关。Logistic回归分析显示意识水平及出院时NHISS评分是拔管的独立影响因素。该模型Hosmer-Lemeshow检验的χ^(2)值为8.232(P=0.411),预测概率ROC曲线下面积为0.916,提示该模型拟合优度优良。结论:脑卒中恢复期气管切开患者能否拔管与年龄、脑卒中类型、NHISS评分、意识状态等因素有关。

Objective:To investigate the clinical characteristics and risk factors of extubation in patients with tracheotomy after stroke.Methods:The clinical data of 72 patients with tracheotomy after stroke who were hospitalized in the Department of Hyperbaric Oxygen Rehabilitation,General Hospital of Southern Theater Command from 2015 to 2023 were retrospectively analyzed.Binary logistic regression method was used to analyze the factors that may affect extubation.Results:Univariate analysis showed that age,NHISS score at admission,NHISS score at discharge,Stroke type,and consciousness state at discharge were correlated with extubation.Logistic regressionanalysis showed that NHISS score and consciousness state at discharge score was an independent factor for extubation.The 2 value of the Hosmer-Lemeshow test was 8.232(P=0.411),and Area Under Curve(AUC)of ROC is 0.916 suggesting that the goodness of fit of this model is outstanding(χ^(2)=0.9166).Conclusion:The ability of extubation in patients with tracheotomy after stroke is related to age,Stroke type,NHISS score and state of consciousness.