下颌第三磨牙拔除术后出血风险模型的构建

doi:10.19438/j.cjoms.2023.05.009

摘要/Abstract

摘要： 目的：探讨下颌第三磨牙拔除术后出血的风险因素并建立预测模型,为临床决策提供参考。方法：收集610例下颌第三磨牙拔除术后患者的病例资料,分析术后出血与患者人口学变量（性别）、牙解剖变量（与平面关系、阻生角度）及其他变量（牙周炎、术中麻醉药品、术中翻瓣、术后处理方式、止血材料及方法、术后依从性）的关系。采用SAS 9.4软件包对数据进行统计学分析。结果：610例下颌第三磨牙拔除术后患者的出血发生率为10.33%,63例患者发生出血。多因素logistic回归分析显示,与平面关系、阻生角度、术中翻瓣、术后处理方式、术后依从性均为下颌第三磨牙拔除术后发生出血的独立风险因素。用验证组的病例资料验证预测模型,结果显示预测模型区分度较好（AUC=0.916）,校准度较高（P=0.605）。结论：与平面关系、阻生角度、术中翻瓣、术后处理方式、术后依从性为出血独立风险因素,可作为预测模型的预测因子。

关键词: 第三磨牙, 智牙, 牙拔除术, 出血, 风险因素, 预测模型

Abstract: PURPOSE: To explore the risk factors of bleeding after mandibular third molar extraction and establish a prediction model to provide reference for clinical decision-making. METHODS: Clinical data of 610 cases of mandibular third molar extraction were collected for the study. Association of postextraction bleeding with the patient demographic variables (gender), tooth variables(position, impacted angle) and other variables (periodontitis, intraoperative anesthetic drugs, flap, postoperative treatment, hemostatic materials, patient compliance). SAS 9.4 software package was used to analyze the data. RESULTS: The incidence of postextraction bleeding was 10.33% in 610 patients after mandibular third molars extraction, and 63 patients had postextraction bleeding. Multivariate logistic regression analysis showed that the position, impacted angle, flap, postoperative treatment, patient compliance were independent risk factors for postextraction bleeding of mandibular third molars. The results showed that the prediction model had good differential validity(AUC=0.916), high calibration degree (P=0.605), and certain clinical application value. CONCLUSIONS: The position, impacted angle, flap, postoperative treatment and patient compliance are not only risk factors for postextraction bleeding, but also predictive factors for predictive models.

Key words: Third molar, Wisdom teeth, Tooth extraction, Bleeding, Risk factors, Prediction model

中图分类号:

R782.1

王建荣, 孙静, 赵树红, 尚将. 下颌第三磨牙拔除术后出血风险模型的构建[J]. 中国口腔颌面外科杂志, 2023, 21(5): 479-485.

WANG Jian-rong, SUN Jing, ZHAO Shu-hong, SHANG Jiang. Study on risk model for postextraction bleeding of mandibular third molars[J]. China J Oral Maxillofac Surg, 2023, 21(5): 479-485.

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