实用临床医药杂志2025，Vol.29Issue(3)：75-79,83,6.DOI:10.7619/jcmp.20242083
急诊重症监护室经口气管插管患者口腔黏膜压力性损伤的危险因素分析及风险预测模型构建
Risk factor and prediction model construction for oral mucosal pressure injuries in patients with endotracheal intubation in emergency intensive care unit
摘要
Abstract
Objective To explore the risk factors for oral mucosal pressure injuries(OMPI)in patients with endotracheal intubation in the emergency intensive care unit(EICU)and to construct a nomogram prediction model based on these factors.Methods A case-control study design was adopt-ed to retrospectively collect clinical data from 209 adult patients with endotracheal intubation admitted to EICU.The patients were divided into OMPI group(53 patients)and non-OMPI group(156 pa-tients)based on whether OMPI occurred during the observation period.The clinical data of the two groups were analyzed,and multivariate Logistic regression analysis was used to screen risk factors for OMPI in patients with endotracheal intubation in the EICU.R software was used to draw a nomogram prediction model,and the predictive performance of the model was evaluated through the receiver oper-ating characteristic(ROC)curve,calibration curve,and decision curve analysis.Results Statistical-ly significant differences were observed between the two groups in prone position ventilation,vasocon-strictor use,consciousness at the time of intubation,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score at the time of intubation,and duration of endotracheal intubation(P＜0.05).The results of multivariate Logistic regression analysis showed that prone position ventilation(OR=2.545,95％CI,1.261 to 5.135),vasoconstrictor use(OR=1.984,95％CI,1.162 to 3.387),inability to express complaints at time of intubation(OR=3.618,95％CI,1.891 to 6.924),high APACHE 11 score(OR=2.394,95％CI,1.322 to 4.336),and long duration of endotracheal in-tubation(OR=3.995,95％CI,1.857 to 8.593)were all risk factors for OMPI in patients with en-dotracheal intubation in the EICU(P＜0.05).ROC curve analysis showed that the area under the curve of the nomogram prediction model was 0.881;calibration curve analysis showed that the mean absolute error between the predicted probability and the actual probability of the model was 0.016;and decision curve analysis showed that the prediction model had practical value in clinical practice.Conclusion Prone position ventilation,vasoconstrictor use,inability to express complaints at the time of intubation,high APACHE Ⅱ score,and long duration of endotracheal intubation are all risk factors for OMPI in patients with endotracheal intubation in the EICU.The nomogram model con-structed based on these factors has good predictive performance for OMPI risk.关键词
口腔黏膜/压力性损伤/急诊重症监护室/气管插管/危险因素/列线图模型Key words
oral mucosal/pressure injuries/emergency intensive care unit/endotracheal in-tubation/risk factors/nomogram model分类
临床医学引用本文复制引用
张英,潘瑜,黄玉凤,倪月华,周芸..急诊重症监护室经口气管插管患者口腔黏膜压力性损伤的危险因素分析及风险预测模型构建[J].实用临床医药杂志,2025,29(3):75-79,83,6.基金项目
江苏省苏州市科技计划项目(YK202037) （YK202037）
