关键词: 口腔颌面间隙感染, 机械通气, 延迟脱机, 危险因素

Abstract: PURPOSE: To analyze the risk factors of prolonged mechanical ventilation(PMV) in patients with oral and maxillofacial space infections(MSI) after surgery under general anesthesia. METHODS: A total of 74 patients with oral and maxillofacial multiple space infection who underwent general anesthesia in Department of Emergency, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The medical history, results of auxiliary examinations, and clinical outcomes of patients were collected for analysis. Univariate and multivariate logistic regression analyses were performed to assess risk factors associated with PMV. Receiver operator characteristic curve (ROC curve) was performed to evaluate the predictive value of related factors for PMV. Statistical analysis was conducted with SPSS 11.5 software package. RESULTS: The mean age of the patients was (62.53± 17.74) years , while 62.2% were male. The median duration of mechanical ventilation was 2 days and 43.3% were in PMV group. The incidence of postoperative pneumonia in PMV group was significantly higher than non-PMV group(P=0.04) and LOS was longer in PMV group(P=0.01). Multivariate analysis showed that the infections involved parapharyngeal space(OR=4.06,95%CI: 1.38-12.04, P=0.01) and arterial carbon dioxide partial pressure(PaCO₂)(OR=1.10, 95%CI: 1.02-1.18, P=0.01) before SBT test were independent risk factors for PMV. The serum level of prealbumin(PAB) in PMV group was significantly lower than non-PMV group(P< 0.01). ROC curve analysis showed that PAB had good predictive value for PMV, the area under the ROC curve（AUC）was 0.772（95%CI: 0.602-0.843, P=0.01). CONCLUSIONS: PMV could be detrimental to prognosis of patients with MSI. Identifying risk factors of PMV early is conductive to clinical intervention and successful weaning after surgery.

Key words: Oral and maxillofacial space infections, Mechanical ventilation, Prolonged mechanical ventilation, Risk factor