麻醉安全与质控2025，Vol.7Issue(4)：289-294,6.DOI:10.3969/j.issn.2096-2681.2025.04.004
老年患者腹腔镜直肠癌术后麻醉恢复室发生低氧血症危险因素分析及预测模型构建
Analysis of risk factors and construction of a nomogram model for PACU hypox-emia in elderly patients after laparoscopic surgery for rectal cancer
摘要
Abstract
Objective To investigate the risk factors for post-anesthesia care unit hypoxemia in elderly patients after laparoscopic sur-gery for rectal cancer and to construct a nomogram model.Methods A retrospective analysis was conducted on 1236 elderly patients who underwent laparoscopic rectal cancer surgery under general anesthesia at Gansu Provincial People's Hospital from January 2021 to January 2024.The patients were randomly divided into a training group(n=873)and a validation group(n=363)at a ratio of 7∶3 by using ran-dom number table method.According to whether hypoxemia[arterial oxygen partial pressure/fraction of inspired oxygen(PaO2/FiO2)≤300 mmHg(1 mmHg=0.133 kPa)]occurred within 30 min after extubation in PACU,univariate analysis was performed on the general conditions,preoperative smoking history and comorbidities,preoperative examinations,surgical and anesthesia-related factors of the two groups.Factors with statistically significant differences between the two groups were included in the multivariate logistic regression analysis to identify the risk factors for PACU hypoxemia in elderly patients after laparoscopic surgery.Results The incidence of PACU hypoxemia in the training group was 20.06％.Univariate analysis showed that the American Society of Anesthesiologists(ASA)classification,age,operation time,body mass index(BMI),cisatracurium dosage,arterial partial pressure of carbon dioxide(PaCO2),arterial partial pres-sure of oxygen(PaO2),and forced expiratory volume in one second(FEV1)were statistically significant(P＜0.05).These factors were included in the multivariate logistic regression analysis and a nomogram prediction model was constructed,which achieved an area under curve of 0.74 in the training group and 0.70 in the validation group.Calibration curves were close to the ideal curve,and decision curve analysis showed favorable performance in the range of 0.2-0.6.Conclusion Independent risk factors for PACU hypoxemia in elderly patients after laparoscopic rectal cancer surgery include ASA grade,age,duration of surgery,BMI,dose of cisatracurium,PaCO2,PaO2,and FEV1.关键词
老年/腹腔镜/直肠癌/低氧血症Key words
elderly/laparoscopy/rectal cancer/hypoxemia引用本文复制引用
李婷,邓菲,彭超..老年患者腹腔镜直肠癌术后麻醉恢复室发生低氧血症危险因素分析及预测模型构建[J].麻醉安全与质控,2025,7(4):289-294,6.基金项目
甘肃省人民医院院内基金(21GSSYC-31) （21GSSYC-31）
甘肃省麻醉与脑功能临床医学研究中心项目(21JR7RA675) （21JR7RA675）
