妇科腹腔镜恶性肿瘤根治术后DVT发生风险预测模型构建  

Establishing a risk prediction model of DVT after gynecological laparoscopic radical resection of malignant tumor

作　　者：曹晓东 彭琼 Cao Xiaodong;Peng Qiong(Operating Room,Foshan Nanhai District People's Hospital,Foshan Guangdong 528226,P.R.China)

机构地区：[1]佛山市南海区人民医院手术室,广东佛山528226

出　　处：《中国计划生育和妇产科》2025年第3期83-86,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：佛山市卫生健康局医学科研课题(项目编号:20220149)。

摘　　要：目的 基于术中相关指标建立妇科腹腔镜恶性肿瘤根治术后深静脉血栓(deep vein thrombosis,DVT)发生风险预测模型。方法 选择2021年1月至2023年12月在佛山市南海区人民医院进行妇科腹腔镜恶性肿瘤根治术治疗的患者124例,统计其DVT发生情况,根据术后是否发生DVT将其分为DVT组和无DVT组,比较两组临床资料。采用Logistic回归分析探讨妇科腹腔镜恶性肿瘤根治术后患者DVT发生的影响因素,并构建术后DVT发生预测模型。结果 124例患者中有20例术后发生DVT,发生率为16.13%。DVT组年龄、BMI≥24 kg/m^(2)、糖尿病史、术中气腹压≥15 mmHg比率、手术时间>2 h比率均大于无DVT组,术中使用保温毯比率低于无DVT组(P<0.05)。多因素Logistic回归分析显示,年龄、BMI、术中使用保温毯、术中气腹压、手术时间是患者术后发生DVT的影响因素(P<0.05)。以年龄、BMI、术中使用保温毯、术中气腹压、手术时间构建患者术后DVT发生的预测模型,H-L检验结果显示模型拟合度佳(P<0.05)。ROC曲线显示,该模型AUC=0.920,最佳截断值灵敏度和特异度分别为87.50%、86.54%。结论 妇科腹腔镜恶性肿瘤根治术后DVT发生率较高,其影响因素包括年龄、BMI、术中使用保温毯、术中气腹压、手术时间,综合分析上述影响因素构建理想的风险预测模型可用来评估妇科腹腔镜恶性肿瘤根治术后DVT发生风险。Objective To establish a risk prediction model of deep vein thrombosis(DVT) after radical resection of gynecological laparoscopic malignant tumor based on intraoperative related indexes.Methods 124 patients who underwent radical gynecological laparoscopic surgery for malignant tumor in Foshan Nanhai District People's Hospital from January 2021 to December 2023 were selected,and the incidence of DVT was counted.According to whether DVT occurred after surgery,the patients were divided into DVT group and non-DVT group,and the clinical data of the two groups were collected and compared.Logistic regression analysis was used to explore the influencing factors of DVT after radical gynecological laparoscopic surgery for malignant tumor,and a prediction model of DVT after surgery was constructed.Results DVT occurred in 20 of 124 patients after operation,and the incidence of DVT was 16.13%.The age,the rate of BMI≥24 kg/m~2,diabetes history,the rate of pneumoperitoneum pressure≥15 mmHg during operation and the rate of operation time>2 hours in DVT group were all higher than those in non-DVT group,the rate of using thermal blanket during operation was lower than that in non-DVT group(P<0.05).Multivariate Logistic regression analysis showed that age,BMI,use of thermal blanket during operation,pneumoperitoneum pressure during operation and operation time were the influencing factors of postoperative DVT(P<0.05).The prediction model of postoperative DVT was established based on age,BMI,use of insulation blanket during operation,intraoperative abdominal pressure,and surgical time.The H-L test results showed that the model fit well(P<0.05).The analysis of ROC curve showed that the AUC value of the model was 0.920,and the sensitivity and specificity of taking the best cutoff value were 87.50% and 86.54%,respectively.Conclusion The incidence of DVT after gynecological laparoscopic radical resection of malignant tumor is high,and its influencing factors include age,BMI,use of thermal blanket during operation,intraoperative pneum

关 键 词：妇科 恶性肿瘤 腹腔镜 深静脉血栓 预测模型 术中指标 

分 类 号：R737.3[医药卫生—肿瘤] R543.6[医药卫生—临床医学]