反流性食管炎患者行无痛胃镜检查发生呼吸相关不良事件的影响因素分析及列线图模型构建OA
Analysis of influencing factors of respiratory-related adverse events and construction of a dynamic nomogram model in patients with reflux esophagitis undergoing painless gastroscopy
目的 探讨反流性食管炎(reflux esophagitis,RE)患者行无痛胃镜检查时发生呼吸相关不良事件(呛咳、低氧血症等)的影响因素,并构建列线图模型.方法 选择2025年1月25日至2026年1月15日于首都医科大学附属北京朝阳医院3个院区行无痛胃镜的患者,纳入胃镜检查诊断RE的患者共268例,采取麻醉清醒后调查问卷的方式收集资料,根据胃镜检查是否发生呼吸相关不良事件分为不良事件组(n=80)和非不良事件组(n=188),比较两组基线特征、RE分级、幽门螺旋杆菌(Helicobacter pylori,Hp)感染、食管裂孔疝/贲门松弛等多种因素,采用单因素及多因素logistic回归分析独立危险因素,并构建动态列线图模型.结果 呼吸相关不良事件发生率为29.9％(80/268),其中低氧23例(8.5％),呛咳(大于5次)56例(20.8％),误吸1例(0.3％),多因素logistic回归分析,习惯性打鼾(OR=2.048,95％CI 1.039～4.039)、吸烟史(OR=3.144,95％CI 1.449～6.822)、食管裂孔疝/贲门松弛(OR=10.290,95％CI 5.045～20.97)、Los Angeles 分级升高(OR=2.172,95％CI 1.224～3.857)、胃内容物体积(每 10 mL,OR=1.100,95％CI 1.001～1.209)是发生呼吸相关不良事件的独立危险因素(P＜0.05).结论 对于RE人群行无痛胃镜检查,习惯性打鼾、吸烟史、食管裂孔疝/贲门松弛、Los Angeles分级升高及胃内容物体积增加是RE患者行无痛胃镜检查发生呼吸相关不良事件的独立危险因素,基于此,医护人员可在无痛胃镜检查前对RE人群进行风险分级,从而采取适当的预防保护措施.
Objective To investigate the influencing factors of respiratory-related adverse events(such as cough and hypoxemia)in patients with reflux esophagitis(RE)undergoing painless gastroscopy,and to construct a nomogram model for this population.Methods A total of 268 patients diagnosed with RE by painless gastroscopy were enrolled from three campuses of Beijing Chaoyang Hospital Affiliated to Capital Medical University between January 25,2025 and January 15,2026.Clinical data were collected via a questionnaire survey after the patients regained consciousness from anesthesia.According to the occurrence of respiratory-related adverse events during gastroscopy,the patients were divided into the adverse event group(n=80)and the non-adverse event group(n=188).Baseline characteristics,RE grading,Helicobacter pylori(Hp)infection,hiatal hernia/cardiac relaxation and other relevant factors were compared between the two groups.Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors,and a dynamic nomogram model was further constructed based on the identified factors.Results The overall incidence of respiratory-related adverse events was 29.9％(80/268),including 23 cases of hypoxemia(8.5％),56 cases of cough(≥5 times,20.8％),and 1 case of aspiration(0.3％).Multivariate logistic regression analysis revealed that habitual snoring(OR=2.048,95％CI 1.039-4.039),smoking history(OR=3.144,95％CI 1.449-6.822),hiatal hernia/cardiac relaxation(OR=10.290,95％CI 5.045-20.97),elevated Los Angeles classification(OR=2.172,95％CI 1.224-3.857)and gastric content volume(per 10 mL,OR=1.100,95％CI 1.001-1.209)were independent risk factors for respiratory-related adverse events(P＜0.05).Conclusion For RE patients undergoing painless gastroscopy,habitual snoring,smoking history,hiatal hernia/cardiac relaxation,elevated Los Angeles classification and increased gastric content volume are independent risk factors for respiratory-related adverse events during the examination.Based on these factors,medical staff can conduct risk stratification for RE patients before painless gastroscopy,and thus implement appropriate preventive and protective measures.
刘振越;刘心娟;于剑锋;郭怀珠;高颖新;李超;卢迪;刘晓
首都医科大学附属北京朝阳医院消化内科,北京 100020首都医科大学附属北京朝阳医院消化内科,北京 100020首都医科大学附属北京朝阳医院消化内科,北京 100020首都医科大学附属北京朝阳医院消化内科,北京 100020首都医科大学附属北京朝阳医院消化内科,北京 100020首都医科大学附属北京朝阳医院消化内科,北京 100020首都医科大学附属北京朝阳医院消化内科,北京 100020首都医科大学附属北京朝阳医院消化内科,北京 100020
医药卫生
反流性食管炎无痛胃镜呼吸相关不良事件列线图模型
reflux esophagitispainless gastroscoperespiratory related adverse eventslinechart model
《中国实用内科杂志》 2026 (4)
308-314,7
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