个体化预测梗阻性乙状结肠癌患者预防性肠造口回纳的风险Nomgram模型的建立  

The Establishment of Nomgram Model for Individualized Prediction of the Risk of Prophylactic Enterostomy in Patients with Obstructive Sigmoid Colon Cancer

作　　者：何璐 郭思思[1] 周丹[1] 谭勤 蒋琳 HE Lu;GUO Si-si;ZHOU Dan;TAN Qin;JIANG Lin(Department of Gastrointestinal Surgery,People's Hospital of Deyang City,Deyang Sichuan,618000)

机构地区：[1]德阳市人民医院胃肠外科,四川德阳618000

出　　处：《山西大同大学学报（自然科学版）》2022年第2期70-74,共5页Journal of Shanxi Datong University(Natural Science Edition)

基　　金：德阳市重点科学技术研究项目[2018SZS058]。

摘　　要：目的 探讨梗阻性乙状结肠癌患者预防性肠造口回纳的风险并建立Nomgram模型。方法 选取肠造口的乙状结肠癌患者104例,根据肠造口回纳时间分为延迟回纳组40例,正常回纳组64例。分析数据并建立相关Nomgram预测模型。结果 两组患者在肿瘤距肛缘的距离、术后辅助化疗、新辅助治疗、吻合口狭窄和吻合口漏方面的差异具有统计学意义。肿瘤距肛缘的距离、术后辅助化疗和吻合口漏是肠造口回纳延迟的独立危险因素。建立列线图模型,并进行验证,C-index指数为0.740(95%CI:0.691~0.789)。结论 肿瘤距肛缘的距离、术后辅助化疗和吻合口漏是影响梗阻性乙状结肠癌患者预防性肠造口回纳的独立危险因素;所建列线图预测模型具有良好的精准度和区分度。Objective To explore the risk of prophylactic enterostomy in patients with obstructive sigmoid colon cancer and establish Nomgram model. Methods 104 patients with enterostomy were selected. According to the time of enterostomy, 40 patients were in delayed group and 64 in normal group. Analyze the data and establish the relevant Nomgram prediction model. Results The distance between tumor and anal margin, postoperative adjuvant chemotherapy, neoadjuvant treatment, anastomotic stenosis and anastomotic leakage were statistically significant. The distance between the tumor and the anal margin, postoperative adjuvant chemotherapy and anastomotic leakage were independent risk factors for the delay of enterostomy. The Nomograph model was established and verified. The C-index index was 0.740(95% CI: 0.691-0.789). Conclusion The distance between the tumor and the anal margin, postoperative adjuvant chemotherapy and anastomotic leakage are independent risk factors for the prevention of enterostomy in patients with obstructive sigmoid colon cancer;the nomograph prediction model in this study has good accuracy and discrimination.

关 键 词：梗阻性乙状结肠癌 预防性肠造口 回纳延迟 Nomgram模型 

分 类 号：R245.3[医药卫生—针灸推拿学]