基于列线图模型对肺癌胸腔镜术后并发 肺部感染的临床预测  

Clinical Prediction of Lung Cancer Complicated with Pulmonary Infection After Thoracoscopic Surgery Based on Nomogram Model

作　　者：张秀强[1] 杨涛[1] ZHANG Xiuqiang;YANG Tao(Department of Thoracic Surgery,Tianjin Fifth Central Hospital,Tianjin 300450,China)

机构地区：[1]天津市第五中心医院胸外科,天津300450

出　　处：《肿瘤防治研究》2023年第1期52-57,共6页Cancer Research on Prevention and Treatment

基　　金：天津市滨海新区科技项目(BHXQKJXMSF-2018-07)。

摘　　要：目的分析肺癌患者胸腔镜根治术后并发肺部感染的危险因素并建立预测列线图模型。方法选取2018年1月至2021年10月接受胸腔镜根治术的315例原发性肺癌患者作为研究对象,据患者术后是否发生肺部感染分为肺部感染组和非肺部感染组。收集两组临床资料进行单因素和回归分析,得出独立预测因素,基于此构建列线图风险模型并对该模型进行预测效能评价。结果患者年龄≥62.5岁、吸烟指数≥100、PEF≤72.1 ml/s、TNM分期为Ⅲ/Ⅳ期和手术时间≥188.5 min是肺癌患者胸腔镜根治术后并发肺部感染的独立危险因素(P<0.05)。基于以上影响因素建立列线图风险模型,验证结果显示,模型一致性指数(C-index)为0.909,校正曲线显示该列线图模型具有良好的区分度及一致性。结论肺癌患者年龄、吸烟指数、TNM分期、PEF和手术时间与胸腔镜术后发生肺部感染具有密切关系,基于此建立的列线图模型对于感染高危患者的识别和降低术后并发症有一定意义。Objective To analyze the risk factors of lung cancer patients complicated with pulmonary infection after thoracoscopic surgery and establish a predictive nomogram model.Methods A total of 315 patients with primary lung cancer who had undergone thoracoscopic surgery from January 2018 to October 2021 in our hospital were divided into two groups according to the incidence of pulmonary infection.Two groups of clinical data were collected for single-factor and regression analyses,and independent predictors were obtained.On this basis,a risk model was constructed and its predictive effectiveness was evaluated.Results The independent risk factors of lung cancer patients complicated with pulmonary infection after thoracoscopic radical operation were as follows:age≥62.5 years,smoking index≥100,PEF≤72.1 ml/s,TNM stageⅢ/Ⅳ,and operation time≥188.5 min(P<0.05).Based on the above factors,the risk model of the column chart was established.Model-verification results showed that the C-index of the model was 0.909,and the correction curve showed that the column chart model had good differentiation and consistency.Conclusion Lung cancer patients’age,smoking index,TNM stage,PEF,and operation time are closely related to pulmonary infection after thoracoscopic radical operation.The nomogram model is useful for identifying high-risk patients and reducing postoperative complications.

关 键 词：肺部感染 肺癌 胸腔镜 列线图模型 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]