胃癌术后患者肺部并发症风险预测logistic回归模型的建立  

Establishment of logistic regression model for predicting the risk of pulmonary complications in patients with gastric cancer after operation

作　　者：王芳 朱晓素 王丽华 WANG Fang;ZHU Xiaosu;WANG Lihua(Department of General Surgery,the 904th Hospital of Joint Logistic Support Force of the Chinese People’s Liberation Army,Jiangsu Province,Wuxi 214000,China;Operating Room,Wuxi No.5 People’s Hospital,Jiangsu Province,Wuxi 214000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇四医院普外科,江苏无锡214000 [2]江苏省无锡市第五人民医院手术室,江苏无锡214000

出　　处：《中国医药导报》2023年第5期116-119,共4页China Medical Herald

基　　金：江苏省自然科学基金青年项目(BK20190601)。

摘　　要：目的探讨胃癌患者术后发生肺部并发症风险预警模型建立及相关因素,为临床预防提供参考。方法选取中国人民解放军联勤保障部队第九〇四医院2018年5月至2020年5月胃癌手术后并发肺部并发症的患者60例作为病例组,同期手术后未发生肺部并发症的患者60例作为对照组。采用单因素及多因素logistic回归模型建立肺部并发症风险预警模型系统,分析胃癌患者术后发生肺部并发症风险的相关因素。结果病例组吸烟、开腹手术方式、手术出血量≥300 ml、清扫淋巴结数目≥25个、术前血蛋白<35 g/L、合并慢性阻塞性肺疾病、合并糖尿病、术后发生吻合口瘘比例高于对照组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,吸烟、开腹手术方式、清扫淋巴结数目≥25个、术前血蛋白<35 g/L、合并慢性阻塞性肺疾病、合并糖尿病、术后发生吻合口瘘是胃癌患者手术后发生肺部并发症的独立危险因素(OR>1,P<0.05)。结论通过建立胃癌患者术后肺部并发症风险预警模型,可有效发现相关风险因素,临床可针对风险人群提出针对性的干预措施。Objective To explore the establishment of risk warning model and related factors of postoperative pulmonary complications in patients with gastric cancer,and to provide reference for clinical prevention.Methods Sixty patients with gastric cancer complicated with lung complications after surgery in the 904th Hospital of Joint Logistic Support Force of the Chinese People’s Liberation Army from May 2018 to May 2020 were selected as the case group and 60 patients with no lung complications after surgery during the same period were selected as the control group.The risk warning model system of lung complications was established by univariate and multivariate logistic regression models to analyze the risk factors of postoperative lung complications in patients with gastric cancer.Results The rates of smoking,laparotomy,surgical bleeding≥300 ml,number of lymph nodes dissected≥25,preoperative blood protein<35 g/L,combined with chronic obstructive pulmonary disease,combined with diabetes,and postoperative anastomotic fistula in case group were higher than those in control group,and the differences were statistically significant(P<0.05).Logistic regression analysis results showed that smoking,laparotomy,number of lymph nodes dissected≥25,preoperative blood protein<35 g/L,combined with combined with chronic obstructive pulmonary disease,diabetes,combined with and postoperative anastomotic fistula were independent risk factors for postoperative pulmonary complications in patients with gastric cancer(OR>1,P<0.05).Conclusion By establishing the risk early warning model of postoperative pulmonary complications in patients with gastric cancer,relevant risk factors can be effectively found,and targeted intervention measures can be proposed for the risk groups in clinic.

关 键 词：肺部并发症 风险预警模型 护理 胃癌 

分 类 号：R734.2[医药卫生—肿瘤]