卵巢癌术后静脉血栓栓塞风险预测模型的建立及验证  

Establishment and validation of a risk prediction model for venous thromboembolism after ovarian cancer surgery

作　　者：许珍珍 梅慧红[1] 黄冬冬[1] 胡琼霜[1] XU Zhenzhen;MEI Huihong;HUANG Dongdong;HU Qiongshuang(Ward of Gynecology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,Zhejiang,China)

机构地区：[1]温州医科大学附属第一医院妇科162病区,浙江温州325015

出　　处：《中国现代医生》2023年第31期108-112,共5页China Modern Doctor

摘　　要：目的探讨卵巢癌术后发生静脉血栓栓塞(venous thromboembolism,VTE)的影响因素,以此建立列线图模型。方法回顾性收集2020年1月至2021年12月温州医科大学附属第一医院因卵巢癌入院并行手术治疗的245例患者的临床信息,根据术后B超结果将其分为血栓组(n=55)和非血栓组(n=190)。采用单因素和多因素Logistic回归分析,筛选出卵巢癌患者术后发生VTE的影响因素,建立列线图模型,利用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)检验效果。结果多因素Logistic分析结果显示,年龄、手术时间、国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)分期和术后D-二聚体均是卵巢癌患者术后发生VTE的独立影响因素(P<0.05)。列线图模型的曲线下面积为0.907,敏感度87.3%,特异性81.1%,Hosmer-Lemeshow检验拟合度较好(χ^(2)=3.834,P=0.872);列线图的校准曲线显示预测值同实测值基本一致。结论基于年龄、手术时间、FIGO分期和术后D-二聚体建立的列线图的预测效能较好,具有一定的临床价值。Objective To investigate the influencing factors of venous thromboembolism(VTE)after surgery for ovarian cancer,and to establish a nomogram model.Methods Clinical data of 245 patients admitted to the First Affiliated Hospital of Wenzhou Medical University for ovarian cancer and undergoing surgical treatment from January 2020 to December 2021 were retrospectively collected,and they were divided into thrombus group(n=55)and non-thrombus group(n=190)according to postoperative B-ultrasound results.Univariate analysis and multivariate Logistic regression analysis were used to screen out the influencing factors of postoperative VTE in ovarian cancer patients,establish a nomogram model,and use receiver operating characteristic(ROC)curve to test the effect.Results Multivariate Logistic analysis showed that age,operation time,International Federation of Gynecology and Obstetrics(FIGO)stage and postoperative D-dimer were independent factors affecting postoperative VTE in ovarian cancer patients(P<0.05).The area under the curve of the nomogram model was 0.907,the sensitivity was 87.3%,the specificity was 81.1%,and the Hosmer-Lemeshow test fit was good(χ^(2)=3.834,P=0.872).The calibration curve of the nomogram showed that the predicted value was basically consistent with the measured value.Conclusion The nomogram based on age,operation time,FIGO stage and postoperative D-dimer has good predictive efficacy and has certain clinical value.

关 键 词：卵巢癌 静脉血栓栓塞 影响因素 列线图 预测模型 

分 类 号：R619[医药卫生—外科学]