腹腔镜胃癌根治术术中低体温发生的危险因素分析及预测模型构建  

Risk factors analysis and prediction model construction of hypothermia during laparoscopic radical gastrectomy for gastric cancer

作　　者：周博 史素玲 尤炎丽[2] 焦丹丹[2] 贺欣欣[2] 李君[1,2] 吉晖晖 李明明[2] ZHOU Bo;SHI Suling;YOU Yanli;JIAO Dandan;HE Xinxin;LI Jun;JI Huihui;LI Mingming(School of Nursing,Henan University of Science and Technology,Luoyang 471003;the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学护理学院,河南洛阳471003 [2]河南科技大学第一附属医院,河南洛阳471000

出　　处：《临床医学研究与实践》2024年第12期26-30,共5页Clinical Research and Practice

摘　　要：目的 分析腹腔镜胃癌根治术术中低体温发生的危险因素并构建列线图预测模型。方法 回顾性分析2021年1月至2022年8月行腹腔镜胃癌根治术的287例患者的临床资料。根据术中是否发生低体温将患者分为低体温组和非低体温组。采用单因素分析与多因素Logistic回归分析探讨腹腔镜胃癌根治术术中低体温发生的独立危险因素,基于此构建列线图预测模型并验证其效果。结果 287例患者中,103例发生低体温,低体温发生率为35.89%。低体温组的年龄大于非低体温组,手术时长、麻醉时长、手术等待时长长于非低体温组,术中尿量、出血量、补液量、二氧化碳(CO_(2))进气量多于非低体温组,高血压糖尿病合并症史占比高于非低体温组(P<0.05)。多因素Logistic回归分析结果显示,年龄、手术等待时长、高血压糖尿病合并症史是影响腹腔镜胃癌根治术术中低体温发生的独立危险因素(P<0.05)。根据独立风险因素建立的列线图预测模型的受试者工作特征(ROC)的曲线下面积(AUC)为0.818,Hosmer-Lemeshow检验结果为0.775(P>0.05),表明列线图预测模型与实际结果一致性良好。结论 腹腔镜胃癌根治术术中低体温列线图预测模型对识别术中低体温发生的关键因素具有重要意义。Objective To analyze the risk factors of hypothermia during laparoscopic radical gastrectomy for gastric cancer and construct a nomogram prediction model.Methods The clinical data of 287 patients who underwent laparoscopic radical gastrectomy for gastric cancer from January 2021 to August 2022 were retrospectively analyzed.According to whether hypothermia occurred during the operation,the patients were divided into hypothermia group and non-hypothermia group.Univariate analysis and multivariate Logistic regression analysis were used to screen out the independent risk factors of hypothermia during laparoscopic radical gastrectomy for gastric cancer.Based on this,a nomogram prediction model was constructed and its effect was verified.Results Among the 287 patients,103 cases had hypothermia,and the incidence of hypothermia was 35.89%.The age of the hypothermia group was greater than that of the non-hypothermia group,the operation time,anesthesia time and operation waiting time were longer than those of the non-hypothermia group,the intraoperative urine volume,blood loss,fluid infusion volume and carbon dioxide(CO_(2))intake were more than those of the non-hypothermia group,and the proportion of history of hypertension and diabetes complications was higher than that of the non-hypothermia group(P<0.05).The multivariate Logistic regression analysis results showed that age,operation waiting time,history of hypertension and diabetes complications were independent risk factors for hypothermia during laparoscopic radical gastrectomy for gastric cancer(P<0.05).The area under curve(AUC)of the receiver operating characteristic(ROC)of nomogram prediction model based on independent risk factors was 0.818,and the Hosmer-Lemeshow test result was 0.775(P>0.05),indicating that the nomogram prediction model was in good agreement with the actual results.Conclusion The nomogram prediction model of intraoperative hypothermia in laparoscopic radical gastrectomy for gastric cancer is of great significance to identify the key factors of

关 键 词：腹腔镜胃癌根治术 低体温 列线图 危险因素 

分 类 号：R472.3[医药卫生—护理学]