胃肠癌根治术患者术中低体温预测模型的构建与验证  

Construction and validation of predictive model for intraoperative hypothermia in patients received radical gastrectomy for gastric cancer

作　　者：赵兰红 杨丽[1] 王敏[1] 宋晶 柳召兰 ZHAO Lanhong;YANG Li;WANG Min;SONG Jing;LIU Zhaolan(Affiliated Hospital of Qingdao University,Qingdao,Shandong 266000,China;不详)

机构地区：[1]青岛大学,山东青岛266000 [2]青岛大学附属医院手术室,山东青岛266000 [3]青岛妇女儿童医院,山东青岛266000

出　　处：《中国临床研究》2023年第8期1276-1280,F0003,共6页Chinese Journal of Clinical Research

摘　　要：目的构建并验证胃肠癌根治术患者术中低体温风险的预测模型。方法便利抽样法选取2020年11月至2021年6月于青岛大学附属医院行胃肠癌根治手术的276例患者作为建模组,2021年7月至9月行胃肠癌根治手术的138例患者作为验证组。本研究利用建模组资料分析低体温发生的影响因素,利用logistic回归构建模型,分别利用Hosmer-Lemeshow和受试者操作特征(ROC)曲线下面积(AUC)确定模型的拟合优度和预测效果。采用R软件建立列线图模型,以验证集做外部验证。结果建模组术中低体温发生率为47.1%;最终进入预测模型的因素是年龄、BMI、手术时间、出血量、胶体液量、手术部位和保温方式;预测模型灵敏度为0.754,特异度为0.760,正确率为75.72%。采用模型对验证组进行评估,AUC为0.820,正确率为74.64%。结论本研究构建的预测模型能较好的预测胃肠癌根治手术患者术中低体温发生的风险,可为临床筛选胃肠癌根治手术术中低体温高风险患者提供参考。Objective To construct and verify the risk prediction model for intraoperative hypothermia in patients received radical surgery for gastrointestinal cancer.Methods A total of 276 patients receiving radical gastrointestinal cancer surgery in the Affiliated Hospital of Qingdao University from November 2020 to June 2021 were selected by a convenient sampling as the model group.From July to September 2021,138 patients undergoing radical surgery were served as validation group.The influencing factors of hypothermia were analyzed based on the data in model group,and the model was constructed using logistic regression,which was respectively verified by Hosmer-Lemeshow and AUC(area under the receiver operating characteristic curve)for the goodness of fit and prediction of the model.R software was used to establish the line column diagram of validation set for external validation.Results The incidence rate of intraoperative hypothermia in model group was 47.1%.Age,BMI,operation time,bleeding volume,volume of colloid,surgical site and insulation method were ultimately included in the prediction model,and sensitivity,specificity and actual accuracy of the model were 0.754,0.760 and 75.72%,respectively.In validation group,AUC was 0.820,and the accuracy rate was 74.64%.Conclusion In the patients undergoing radical gastrointestinal cancer surgery,the constructed model can effectively predict the risk of intraoperative hypothermia and provide a reference for the clinical screening of patients with high risk of hypothermia during operation.

关 键 词：胃肠癌根治术 低体温 保温方式 胶体液量 出血量 加温输液仪 

分 类 号：R473.6[医药卫生—护理学]