Logistic回归分析喉癌术后肺部感染的影响因素及防治措施  

Logistic regression analysis of influencing factors and preventive measures of lung infection after laryngeal cancer surgery

作　　者：王昕 聂双 张书嘉 刘磊 耿璨 许丽 WANG Xin;NIE Shuang;ZHANG Shujia;LIU Lei;GENG Can;XU Li(The First People's Hospital of Lianyungang,Lianyungang Jiangsu 222000,China)

机构地区：[1]连云港市第一人民医院(徐州医科大学附属连云港医院)耳鼻咽喉头颈外科,江苏连云港222000 [2]徐州医科大学附属医院介入科,江苏徐州221000 [3]连云港市急救中心信息科,江苏连云港222000 [4]连云港市第一人民医院(徐州医科大学附属连云港医院)护理部,江苏连云港222000

出　　处：《中国急救复苏与灾害医学杂志》2022年第8期1050-1054,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省优势学科建设工程项目(编号:YSHL0813-14)。

摘　　要：目的采用Logistic回归分析喉癌术后肺部感染的影响因素,为临床制定对应性防治措施提供有效信息。方法选取连云港市第一人民医院2017年7月—2021年3月211例喉癌患者作为研究对象,根据术后是否发生肺部感染分为研究组(40例)与对照组(171例)。收集两组临床资料,采用Logistic回归分析喉癌术后肺部感染的影响因素。结果单因素方差分析,年龄、临床分期、合并糖尿病、术前2周应用抗菌药物、术前白蛋白水平、使用呼吸机、手术时间、留置胃管、气管导管拔除时间是喉癌术后肺部感染的影响因素(P<0.05);Logistic回归分析,年龄≥60岁、术前2周应用抗菌药物、使用呼吸机、手术时间≥4 h、留置胃管、气管导管拔除时间≥12 d是喉癌术后肺部感染的独立危险因素,术前白蛋白水平≥25 g/L是喉癌术后肺部感染的独立保护因素(P<0.05);似然比卡方检验显示模型建立具有统计学意义;Wald卡方检验显示模型构建有效;Hosmer-Lemeshow拟合优度检验显示模型拟合效果较好;利用7个独立危险因素建立的Logistic回归模型,根据概率值,绘制受试者工作特征(ROC)曲线,对211个样本进行内部验证,结果显示,该模型预测喉癌术后肺部感染的曲线下面积(AUC)为0.902,95%CI为0.850~0.953,敏感度为87.50%,特异度为83.63%。结论喉癌术后肺部感染的影响因素较多,根据高危因素构建Logistic回归模型能够及早预测术后肺部感染风险,为临床及时制定防治措施提供可靠依据。Objective To use Logistic regression to analyze the influencing factors of lung infection after laryngeal cancer surgery,and to provide effective information for clinical formulation of corresponding prevention and treatment measures.Methods A total of 211 patients with laryngocarcinoma in our hospital from July 2017 to March 2021 were selected as the research objects,and were divided into a study group(40 cases)and a control group(171 cases)according to whether lung infection occurred after surgery.The clinical data of the two groups were collected,and Logistic regression analysis was used to analyze the influencing factors of lung infection after laryngeal cancer surgery.Results One-way analysis of variance,age,clinical stage,diabetes mellitus,application of antimicrobials 2 weeks before surgery,preoperative albumin level,use of ventilator,operation time,indwelling gastric tube,tracheal tube removal time are the lungs after laryngeal cancer surgery Influencing factors of infection(P<0.05);Logistic regression analysis,age≥60 years old,use of antibacterial drugs 2 weeks before surgery,use of ventilator,operation time≥4 h,indwelling gastric tube,tracheal tube removal time≥12 d is the larynx An independent risk factor for lung infection after cancer surgery,preoperative albumin level≥25 g/L is an independent protective factor for lung infection after surgery for laryngeal cancer(P<0.05);likelihood ratio chi-square test shows that the model is statistically established Scientific significance;Wald chi-square test shows that the model is effective;Hosmer-Lemeshow goodness-of-fit test shows that the model fits well;using the logistic regression model established by seven independent risk factors,the receiver operating characteristic(ROC)curve was drawn according to the probability value,and 211 samples were internally verified.The results showed that the area under curve(AUC)predicted by the model was 0.902,95%CI was 0.850~0.953,the sensitivity was 87.50%and the specificity was 83.63%.Conclusion There are many

关 键 词：喉癌 手术 肺部感染 影响因素 LOGISTIC回归模型 防治措施 

分 类 号：R619[医药卫生—外科学]