肺癌化疗患者经外周中心静脉置管相关性血栓的列线图风险预测模型构建  

Construction of the column chart risk prediction model for peripherally inserted central catheter catheterization related thrombosis in lung cancer chemotherapy patients

作　　者：郝媛媛 张伟杰 贾莉[1] Hao Yuanyuan;Zhang Weijie;Jia Li(Department of Oncology,Yuncheng Central Hospital Affiliated to Shanxi Medical University,Yuncheng 044000,Shanxi,China;Department of Vascular Surgery,Yuncheng Central Hospital Affiliated to Shanxi Medical University,Yuncheng 044000,Shanxi,China)

机构地区：[1]山西医科大学附属运城市中心医院肿瘤科,山西运城044000 [2]山西医科大学附属运城市中心医院血管外科,山西运城044000

出　　处：《血管与腔内血管外科杂志》2024年第8期997-1001,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨肺癌化疗患者经外周中心静脉置管(PICC)相关性血栓的列线图风险预测模型。方法收集2021年1月至2023年12月于山西医科大学附属运城市中心医院接受PICC化疗的265例患者的临床资料,采用倾向匹配法按照置管相关性血栓(CRT)发生情况将其分为CRT组37例和NCRT组128例。收集患者相关的临床指标,分析肺癌化疗PICC置管后发生CRT的影响因素,据此构建列线图风险预测模型。结果应用抗血管生成类化疗药物、既往存在血栓史、置管后负重、置管时穿刺次数≥2次均是肺癌化疗患者PICC发生置管CRT的危险因素(OR≥1,P﹤0.05)。根据危险因素绘制的CRT列线图风险预测模型具有较好的准确性(C指数=0.866),受试者工作特征(ROC)曲线下面积(AUC)为0.866,具有较高的应用价值,经外部校正曲线分析具有较好的临床实用性。结论肺癌化疗患者PICC置管后发生CRT的列线图风险预测模型具有理想的临床应用价值,具有较高的预测准确性,临床上可据此量化性评估肺癌经PICC置管化疗患者CRT的发生风险,并给予专项治疗干预,以提高化疗安全性,延长PICC使用时间。Objective To investigate the nomogram risk prediction model of peripherally inserted central catheter(PICC)associated thrombus in patients with lung cancer chemotherapy.Method Clinical data of 265 patients who received PICC chemotherapy in Yuncheng Central Hospital affiliated to Shanxi Medical University from January 2021 to December 2023 were collected.Propensity matching method was used to divide them into catheter related thrombosis catheter related thrombosis(CRT)group(37 cases)and NCRT group(128 cases)according to the incidence of CRT.Clinical indicators related to patients were collected to analyze the influencing factors of CRT after PICC catheterization of lung cancer chemotherapy.Result The use of antiangiogenic chemotherapy drugs,previous history of thrombosis,post-catheterization weight bearing,and catheterization times≥2 were all risk factors for catheterization of PICC CRT in patients with lung cancer chemotherapy(OR≥1,P<0.05).The CRT histogram risk prediction model drawn according to risk factors has good accuracy(C index=0.866),and the receiver operator characteristic(ROC)of area under curve(AUC)was 0.866,which has high application value,and the externally corrected curve analysis has good clinical practicability.Conclusion The nomogram risk prediction model for CRT after PICC catheterization in patients with lung cancer undergoing chemotherapy has ideal clinical application value and high prediction accuracy.It can be used to quantitatively evaluate the risk of catheterization related thrombosis in patients with lung cancer undergoing PICC catheterization,and special therapeutic intervention can be given to improve the safety of chemotherapy and prolong the use time of PICC.

关 键 词：肺癌 化疗 经外周中心静脉置管 置管相关性血栓 危险因素 列线图 

分 类 号：R543[医药卫生—心血管疾病]