血小板/淋巴细胞比率预测肠梗阻导管治疗小肠梗阻病人非手术治疗失败的研究  

Platelet/lymphocyte ratio predicts the failure of non-surgical treatment in patients with small bowel obstruction treated with intestinal obstruction catheter

作　　者：侯志冰 何杨 赵虎 王瑜 王烈 吴再新 HOU Zhi-bing;HE Yang;ZHAO Hu;WANG Yu;WANG Lie;WU Zai xin(Department of General Surgery,900TH Hospital of Joint Logistics Support the Force,PLA,Fuzhou 350001,Fujian,China;Fuzhou Clinical Medical College of Fujian Medical University,Fuzhou 350001,Fujian,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇〇医院普通外科,福建福州350001 [2]福建医科大学福总临床医学院,福建福州350001

出　　处：《肠外与肠内营养》2024年第4期233-238,共6页Parenteral & Enteral Nutrition

基　　金：福建医科大学启航基金(2021QH1323)。

摘　　要：目的:探究血小板/淋巴细胞比值(PLR)对肠梗阻导管治疗的小肠梗阻病人非手术治疗失败的预测价值。方法:回顾性收集中国人民解放军联勤保障部队第九〇〇医院收治的肠梗阻导管治疗的小肠梗阻病人临床资料。Logistic回归分析确定中转手术的独立预测因素。限制性立方样条(RCS)评估PLR和中转手术之间的剂量-反应关系。受试者工作特征(ROC)曲线评价预测模型的效能。结果:共纳入73名肠梗阻导管保守治疗的小肠梗阻病人,25(34.2%)名病人保守治疗后效果不佳中转为手术干预。多因素Logistic回归分析结果显示,PLR是中转手术的独立预测因子(P=0.032)。RCS分析显示,随着PLR的增高,中转手术的风险逐渐增大,两者之间呈非线性相关。ROC曲线显示,将PLR纳入预测模型后可以显著增强其预测效能(均P<0.05)。结论:PLR与肠梗阻导管治疗的小肠梗阻病人中转手术密切相关,两者之间呈非线性关系。将PLR纳入预测模型后可以显著增强其预测效能,从而为临床医生的决策提供参考价值。Objective:To investigate the predictive value of platelet/lymphocyte ratio(PLR)for conversion surgery in patients with small bowel obstruction treated with intestinal obstruction catheter.Methods:The clinical data of patients with intestinal obstruction treated by intestinal obstruction catheter in the 900TH Hospital of Joint Logistics Support the Force were retrospectively collected.Logistic regression analyses were performed to identify independent predictors of conversion surgery.Restricted cubic spline(RCS)curves assessed the dose-response relationship between PLR and conversion surgery.Receiver operating characteristic(ROC)curves assessed the validity of the predictive model.Results:A total of 73 patients with small bowel obstruction treated conservatively with intestinal obstruction catheter were included and 25(34.2%)patients were referred for surgical intervention after poor outcome of conservative treatment.Multivariate logistic regression analysis showed that PLR was an independent predictor of conversion surgery(P=0.032).The RCS analysis showed a non-linear correlation between a progressively higher risk of conversion surgery as the PLR increased.The ROC curves show that the incorporation of PLR into the prediction model significantly enhances its predictive efficacy(All P<0.05).Conclusion:PLR was found to be significantly associated with conversion surgery in small bowel obstruction patients treated with intestinal obstruction catheter,with a non-linear correlation.Incorporating PLR into the prediction model can significantly enhance the predictive efficacy,thus providing reference value for clinicians'decision-making.

关 键 词：小肠肠梗阻 肠梗阻导管:中转手术 

分 类 号：R656.7[医药卫生—外科学]