The Investigation Of Correlated Risk Factor Of Cerebrovascular Accident In Ambo-operation

Objective:In course of the operation and anaesthesia,the complicated cerebrovascular accident as anaesthesia belong to the ones of severe complication of central nervous system in ambo-operation,and it effect on the post-curing of the patients,someone may be mutilated,and then may be dead.Although the prevention and cure of cerebrovascular accident in ambo-operation and the conservation of brain functional constantly are the investigative topic of anesthesiology,the people still can not make out allround,scientific and completely convinced explain,and then there is not standard judge and monitoring means,so the prevention and cure of cerebrovascular accident in ambo-operation still is the troublesome problem during our anaesthesia.Therefore,we choice 23 examples of patients which all take place cerebrovascular accident in abmo-operation to carry out historical control study,set up Logistic regression model of main risk factor,moreover carry out the evaluation of correlated risk factor,to aim at offer the reference of clinical evaluation and forecast for providing the prevention and cure of cerebrovascular accident in abmo-operation, as well as establish compact the foundation for the deep research of clinical prevention and cure technical of cerebrovascular accident in abmo-operation in the future.Methods:This investigation is retrospective study,which consult in 23 patients of accepted operation and final diagnosised cerebrovascular accident in ambo-operation, among this sample,there are 14 patients mutilated and 9 patients dead.In overall patients,possible risk factor which include sexuality,age,epidemiology(whether or not happened cerebrovascular accident),hypertension,drink wine,smoking,body mass index,diabetes,junks,anaesthesia means,blood transfusion and transfusion, partial pressure of carbon dioxide in endexpiratory gas(PETCO₂),body temperature in course of operation,operation means,arrhythmia,blood pressure during operation, and the cure consequence of cerebrovascular accident in ambo-operation carry out investigation,all risk factor undertake historical control study,all factor undertake treatment with the means of digital,and all patients are separated the group of mutilated and the group of dead.Apply to SPSS11.5 software analysis data.Firstly, all data carry out statistical analysis with Fisher's Exact Test,finding out difference factors.Secondly,this difference factors apply to multiple factor forward step-by-step method multielement Logistic regression analysis,with P=0.05 for significance threshold,set up Logistic regression equation:P=B₀+B₁X₁+B₂X₂+... +B_nX_n,calculate relative risk of each factor:OR=EXP(B),finding out the most risk factor of happened cerebrovascular accident in ambo-operation,and evaluation the sensitivity,specificity and accuracy rating of the model predict cerebrovascular accident in ambo-operation.Thirdly,analysising the dependability between this the most risk factor and cerebrovascular accident in ambo-operation.Result:Each risk correlation factor Fisher's Exact Test result of two groups demonstrate the epidemiology(whether or not happened eerebrovascular accident) (P=0.001),hypertension(P=0.029),body mass index(P=0.040),junks(P=0.036), anaesthesia means(P=0.036),partial pressure of carbon dioxide in endexpiratory gas (PETCO₂)(P=0.013),blood pressure during operation(P=0.040)and so on 7 factors have difference in 16 riskcorrelation factor.By means of post-curing of cerebrovascular accident in ambo-operation for dependent variable(mutilated=0; dead=1;),taking this index of 7 factor have statistical significance with Fisher's Exact Test input into forward step-by-step multielement Logistic regression analysis,the result demonstrate the forecast accurate rate is 60.9%in nulli-internalize any variance,the coefficient constant neck is -0.442,at the same time demonstrate if the 4 factors including X3 epidemiology(whether or not happened cerebrovascular accident)(P=0.001),X4 hypertension(P=0.012),X7 body mass index(P=0.027), X16 blood pressure during operation(P=0.027)bring into the equations,the change of equations have statistical significance.Following the next step select,only demonstrate the internalize factors are X3 epidemiology(whether or not happened cerebrovascular accident)and X4 hypertension,at this time the forecast accurate rate is go up from 60.9%to 95.7%,the coefficient of X3 is 3.818,OR=45.5,P=0.004,the coefficient of X4 is 3.096,OR=40.15,P=0.006,meanwhile,demonstrate if X16 blood pressure during operation(P=0.049)bring into the equations,the change of equations have statistical significance,it should reserve in the equations.And finally conclude the equations:P=-0.442+3.818X₃+3.096X₄;from the judge of the model,we can see no matter the likelihood than the three coefficient values all are developing from iteration start to one direction,the last achieve astringe,which explaining whole iterative procedure is healthy,there is not problem;and explaining the model is reasonable to forecast 0 and 1,the possibility all close to 0 and 1,there are only one sample of 0 which was miscarriage of justiced to 1,and from the distribution to see, this sample possiblily is extremely condition,if reintroducte other variable,the result of forecast can not be changed more or less,so the model fundamentally is reasonable. Subsequently carry out dependablity analysis between X3 epidemiology(whether or not happened cerebrovaseular accident),X4 hypertensiorn,X16 blood pressure during operation and eerebrovascular accident in ambo-operation,it demonstrate there are positive correlation between X3,X4,X16 and cerebrovascular accident in ambo-operation(there are as following r=0,724,P=0.001;r=0.524,P=0.010; r=0.460,P=0.027;).Conclusion:The effect on happening of cerebrovaseular accident in ambo-operation result in multiple factor effectiveness:一,In this risk factor,the epidemiology(whether or not happened cerebrovascular accident),hypertension,body mass index,junks,anaesthesia means,partial pressure of carbon dioxide in endexpiratory gas(PETCO₂),blood pressure during operation and so on 7 factors are the important risk factors of causing the happening and causing death of cerebrovascular accident in ambo-operation.二,The 3 risk factors including epidemiology(whether or not happened cerebrovascular accident),hypertension and blood pressure during operation are the important factor of causing the happening and causing death of cerebrovascular accident in ambo-operation,and then epidemiology(whether or not happened cerebrovascular accident)and hypertension are the most important factors. 三,If the patients have happened cerebrovascular accident in Preoperative,have hypertensive disease and hypertension or there is obviously blood pressure fluctuation during operation,which easily lead to patients happened cerebrovaseular accident and dead.