摘要
目的分析扁桃体切除术后疼痛的危险因素,并构建预测术后疼痛的列线图模型。方法选取淮安市第二人民医院行扁桃体切除术患者215例,根据视觉模拟法对疼痛程度测评,并分为疼痛组(154例)和无疼痛组(61例)。采用单因素和多因素Logistic回归分析明确扁桃体切除术后疼痛的危险因素,R软件构建预测术后疼痛的列线图模型,并验证该列线图模型预测术后疼痛的效果。结果术后发生疼痛154例(71.63%)。疼痛组年龄小于无疼痛组,安静的病房环境、冷敷、全麻、加用局麻药、高功能家庭比例低于无疼痛组(P<0.05)。多因素Logistic回归模型结果:未加用局麻药、术后无冷敷、病房环境为嘈杂、麻醉方式为局部、家庭支持为无效或低功能家庭是影响疼痛的独立危险因素,而年龄是保护因素(P<0.05)。列线图模型预测扁桃体切除术后疼痛的ROC曲线下面积为0.919,且Hosmer-Lemeshow检验χ^(2)=6.605,P=0.691,校准曲线斜率接近1,说明预测疼痛风险与实际风险较为吻合。结论基于年龄、冷敷、病房环境、麻醉方式、家庭支持及加用局麻药构建的预测扁桃体切除术后疼痛的列线图模型,可用于预测术后疼痛的风险,对临床改善预后疼痛提供参考。
OBJECTIVE To analyze the risk factors of pain after tonsillectomy,and to construct a nomogram model to predict postoperative pain.METHODS A total of 215 patients who underwent tonsillectomy in our hospital were included in this study,and the pain degree was evaluated according to the visual analogue scale,and they were grouped into pain group and pain-free group.Univariate and multivariate Logistic regression analysis was performed to identify the risk factors of pain after tonsillectomy.R software was used to build a nomogram model for predicting postoperative pain,and verify the effect of the nomogram model in predicting postoperative pain.RESULTS Of the 215 patients,154 patients(71.63%,154/215)developed pain after surgery.The age of the pain group was younger than that of the pain-free group,and the proportion of quiet ward environment,cold compress,general anesthesia,plus local anesthesia,and high-functioning family were lower than those in the pain-free group(P<0.05).Multivariate Logistic regression model found that no local anesthetic,no postoperative cold compress,noisy ward environment,local anesthesia,ineffective family support or low-functioning family were independent risk factors for pain,while age was a protective factor(P<0.05).The area under the ROC curve of the nomogram model for predicting pain after tonsillectomy was 0.919,and the Hosmer-Lemeshow testχ^(2)=6.605,P=0.691,and the slope of the calibration curve was close to 1,indicating that the predicted risk of pain was in good agreement with the actual risk.CONCLUSION The nomograph model to predict the pain after tonsillectomy constructed based on age,cold compress,ward environment,anesthesia mode,family support and the addition of local anesthetics can be used to predict the risk of postoperative pain and provide a reference for clinical improvement of prognosis..
作者
王雪
陈莉
徐泓
邵敏
郭巧玲
怀德
WANG Xue;CHEN Li;XU Hong;SHAO Min;GUO Qiaoling;HUAI De(Department of Otolaryngology,Huai'an Second People's Hospital,Huai'an,Jiangsu,223002,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2023年第2期116-120,共5页
Chinese Archives of Otolaryngology-Head and Neck Surgery
