宫颈癌患者根治术后下肢淋巴水肿发生风险预测模型的构建及应用研究  

Construction and application of a risk prediction model for lower extremity lymphedema after radical resection of cervical cancer

作　　者：何敏 胡蓉娟 林玉霞[1] HE Min;HU Rongjuan;LIN Yuxia(Fujian Cancer Hospital(Cancer Hospital of Fujian Medical University),Department of Gynaecological Oncology,Fuzhou,350014,China)

机构地区：[1]福建省肿瘤医院(福建医科大学附属肿瘤医院)妇科肿瘤科,福州350014

出　　处：《当代护士（中旬刊）》2022年第8期1-4,共4页Modern Nurse

摘　　要：目的探讨宫颈癌患者根治术后发生下肢淋巴水肿的危险因素,构建并验证预测模型的效能。方法选取2017年1月—2019年2月福建省某三甲医院收治的268例宫颈癌患者作为建模组,2019年5月—2019年11月收治的47例宫颈癌患者作为验证组,通过Logistic回归分析筛查高危因素,构建预测模型,并通过验证组验证模型的效能。结果22.8%(61/268)的患者出现下肢淋巴水肿。Logistic回归分析显示,年龄、身体质量指数、盆腔淋巴结清扫、放疗、术后平均站立时间是下肢淋巴水肿的危险因素(P<0.05),风险预测模型的受试者操作特征曲线下面积为0.772(95%CI:0.712~0.832),灵敏度为64.3%,特异度为78.7%,约登指数为0.430。模型的外部验证结果显示,灵敏度为70.0%,特异度为86.5%。结论本研究构建的模型具有良好的效能,可以为医护人员及时对宫颈癌根治术后下肢淋巴水肿高危患者采取有效的预防措施提供借鉴。Objective To investigate the risk factors of lower extremity lymphedema after radical resection of cervical cancer,and to construct and verify the efficacy of prediction model.Methods A total of 268 patients with cervical cancer admitted to a Grade-A tertiary hospital in Fujian Province from January 2017 to February 2019 were collected as the modeling group,and 47 patients with cervical cancer admitted to a Grade-A tertiary hospital in Fujian Province from May 2019 to November 2019 were collected as the validation group.Logistic regression analysis was used to screen the high-risk factors and construct the prediction model,and the efficiency of the model was verified by the validation group.Results A total of 22.8%(61/268)patients developed lower extremity lymphedema.Logistic regression analysis showed that age,body mass index,pelvic lymph node dissection,radiotherapy and postoperative average standing time were risk factors for lower extremity lymphedema(P<0.05).The area under the receiver operating characteristic curve of the risk prediction model was 0.772(95%CI:0.712-0.832),the sensitivity was 64.3%,the specificity was 78.7%,and the Youden index was 0.430.The external validation results of the model showed that the sensitivity was 70.0%and the specificity was 86.5%.Conclusion The model constructed in this study has good efficiency,which can provide reference for medical staff to timely take effective preventive measures for patients at high risk of lower extremity lymphedema after radical resection of cervical cancer.

关 键 词：宫颈癌 下肢淋巴水肿 预测模型 护理 

分 类 号：R473.73[医药卫生—护理学]