老年经蝶垂体瘤术后水钠代谢紊乱的危险因素分析:一项单中心回顾性研究  

Analysis of risk factors for water and sodium metabolism disorders in elderly patients after transsphenoidal pituitary tumor surgery:a single-center retrospective study

作　　者：尉晨 黄莺 吕丽君 杨金花 戚若潮 圣京花 Wei Chen;Huang Ying;Lyu Lijun;Yang Jinhua;Qi Ruochao;Sheng Jinghua(Department of Neurosurgery,Huashan Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华山医院神经外科,上海200040

出　　处：《老年医学与保健》2024年第3期610-615,共6页Geriatrics & Health Care

基　　金：上海市卫生健康委员会面上科研项目(202340168)。

摘　　要：目的分析老年患者经蝶垂体瘤术后发生水钠代谢紊乱的危险因素,构建及验证风险预测模型。方法采用回顾性分析,选取2021年1月—2023年12月于复旦大学附属华山医院神经外科行经蝶垂体瘤手术老年患者429例,通过交叉验证法,按6∶4比例分为建模组(257例)和验证组(172例)。建模组通过二项Logistics回归分析确定危险因素并建立风险预测模型,验证组通过受试者工作特征曲线(ROC)评估模型预测效果。结果二项Logistics回归分析显示:合并糖尿(OR=3.810)、手术时长(OR=1.755)、肿瘤直径(OR=3.531)、术后血糖(OR=3.091)、术后高热(OR=5.111),是术后水钠代谢紊乱的危险因素(P<0.05)。验证组的ROC曲线下面积(AUC)为0.847(95%CI:0.788~0.905,P<0.01),灵敏度为0.692,特异度为0.864,约登指数为0.560。结论本研究构建的风险预测模型对高危老年患者预测效果好,可为临床医护人员提供一定的参考。Objective To analyze the risk factors of water and sodium metabolism disorder in elderly patients after transsphenoidal pituitary tumor surgery,and establish and validate a risk prediction model.Methods A retrospective analysis was conducted.429 elderly patients who underwent transsphenoidal pituitary tumor surgery in Department of Neurosurgery,Huashan Hospital Affiliated to Fudan University from January 2021 to December 2023 were selected.By cross-validation method,they were divided into modeling group(257 cases)and validation group(172 ones)according to a ratio of 6∶4.In the modeling group,the risk factors were identified through binomial logistics regression analysis,and a risk prediction model was established.In the validation group,the predictive effect of the model was evaluated by receiver operating characteristic curve(ROC).Results Binomial logistic regression analysis showed that concurrent diabetes(OR=3.810),surgical duration(OR=1.755),tumor diameter(OR=3.531),postoperative blood glucose(OR=3.091),and postoperative high fever(OR=5.111)were risk factors for postoperative water and sodium metabolism disorders(P<0.05).In the validation group,the area under ROC curve(AUC)was 0.847(95%CI:0.788-0.905,P<0.01),the sensitivity was 0.692,the specificity was 0.864,and Yoden index was 0.56(0.P<0.01).Conclusion The risk prediction model constructed in this study has a good prediction effect on high-risk elderly patients,and can provide a certain reference for clinical medical staff.

关 键 词：老年 经蝶窦垂体瘤手术 水钠代谢紊乱 危险因素 预测模型 

分 类 号：R736.4[医药卫生—肿瘤]