肝癌热消融术后腹痛发生的列线图风险模型构建及评价  

Construction and evaluation of the nomogram risk model for abdominal pain after thermal ablation in patients with primary liver cancer

作　　者：翟红燕 林晨 周贵明[1] 朱心愿 Zhai Hongyan;Lin Chen;Zhou Guiming;Zhu Xinyuan(Department of Ultrasound,General Hospital of Tianjin Medical University,Tianjin City 300000,China;Department of Cardiac and Vascular Surgery,Tianjin Fifth Central Hospital,Tianjin City 300032,China)

机构地区：[1]天津医科大学总医院超声科,天津市300000 [2]天津市第五中心医院心脏大血管外科,天津市300032

出　　处：《中华疼痛学杂志》2024年第5期686-692,共7页Chinese Journal Of Painology

基　　金：天津市卫生健康科技项目面上项目,天津市卫健委(TJWJ2024MS004);天津市优秀特派员项目,天津市科技局(23YDTPJC00460);中华国际医学交流基金会第五届心血管多学科整合思维研究基金(2022-N-01-18)。

摘　　要：目的:通过构建列线图风险模型分析原发性肝癌热消融术后腹痛发生的危险因素及指导临床选择科学合理的围手术期镇痛方法。方法:回顾性分析2024年1月至2024年10月因原发性肝癌于天津医科大学总医院行微波消融术患者的临床与手术资料,按术后有无腹痛发生分为腹痛组和非腹痛组,分别通过单因素分析、Lasso回归及Logistic回归分析得到腹痛发生的独立危险因素,构建列线图风险预测模型,通过ROC曲线及DCA曲线进行模型评价。结果:本研究共纳入230例患者,其中腹痛组105例,非腹痛组125例,回归分析结果显示年龄、肿瘤体积、肿瘤多发以及手术史是热消融术后腹痛发生的独立危险因素,ROC曲线显示列线图模型有较好的预测效能,DCA曲线显示患者可以根据模型从临床治疗中获益。结论:本研究通过回归分析构建肝癌消融术后腹痛发生的列线图风险预测模型,有助于进行腹痛评估及个性化疼痛管理。Objective To establish a nomogram risk model to analyze the risk factors of abdominal pain after thermal ablation in patients with primary liver cancer and to guide clinical scientific and reasonable perioperative analgesia.Methods Clinical data and surgical data of patients undergoing microwave ablation for liver cancer in General Hospital of Tianjin Medical University were retrospectively analyzed,and the patients were divided into abdominal pain group and non-abdominal pain group after surgery.Independent risk factors for abdominal pain were obtained by univariate analysis,Lasso regression analysis and Logistic regression analysis,and then a risk prediction model was constructed.The model was evaluated by receiver operating characteristic(ROC)curve and decision curve analysis(DCA)curve.Results A total of 230 patients were included,with 105 patients in the abdominal pain group and 125 patients in the non-abdominal pain group.Regression analysis results showed that age,tumor volume,tumor frequency and surgical history were independent risk factors for the occurrence of abdominal pain after the operation.ROC curve showed that the nomogram model had good predictive efficacy,and DCA curve showed that patients benefited from clinical treatment according to the model.Conclusions The risk prediction model of abdominal pain after liver cancer ablation was established through regression analysis,which promotes the scientific assessment of the risk of postoperative abdominal pain and the personalized pain management.

关 键 词：肝癌 热消融 腹痛 列线图 

分 类 号：R73[医药卫生—肿瘤]