摘要
目的探讨构建腹腔感染预警评分表对胃肠恶性肿瘤术后发生腹腔感染的预测价值。方法选取2020年1月—2023年1月在医院行胃肠恶性肿瘤术的患者200例,按照术后是否发生腹腔感染分为腹腔感染组23例和非腹腔感染组177例,构建术后腹腔感染风险预测模型,采用Hosmer-Lemeshow检验模型的拟合度,采用受试者工作特征(ROC)曲线分析风险预测模型的价值。结果经单因素分析,年龄、性别、BMI、NRS2002评分、手术方式、手术时间、术中失血量、术后白蛋白、术后血红蛋白、糖尿病、高血压、心脏病、住院时间不是胃肠恶性肿瘤术后腹腔感染的影响因素(P>0.05),术后最高体温、术后最快心率、术后白细胞计数、术后腹痛、术后腹胀、术后降钙素原(PCT)是胃肠恶性肿瘤术后腹腔感染的影响因素(P<0.05)。经多因素二元Logistic分析,术后腹痛、术后腹胀、术后PCT≥2μg/L、术后最高体温≥37.5℃、术后白细胞计数≥9.95×10^(9)/L是胃肠恶性肿瘤术后腹腔感染的危险因素(P<0.05)。Hosmer-Lemeshow拟合度检验显示,χ^(2)=0.949,P=0.996。受试者工作特征(ROC)曲线显示,胃肠恶性肿瘤术后腹腔感染风险模型的曲线下面积(AUC)为0.880,约登指数为0.760,敏感度、特异度分别为78.26%、97.74%,实际应用的准确性为95.50%。结论本研究构建的胃肠恶性肿瘤术后腹腔感染预警评分表预测效果较好,可为胃肠恶性肿瘤术后腹腔感染提供辅助参考。
Objective To explore the predictive value of constructing an early warning scale for abdominal infection on the occurrence of abdominal infection after surgery for gastrointestinal malignant tumors.Methods 200 patients who underwent surgery for gastrointestinal malignant tumors in the hospital from January 2020 to January 2023 were selected and divided into 23 cases of abdominal infection group and 177 cases of nonabdominal infection group according to whether or not abdominal infection occurred in the postoperative period,and then constructed a risk prediction model for postoperative abdominal infection,adopted the Hosmer-Lemeshow test for the model's fit,and analyzed the risk of postoperative abdominal infection by the work characteristics(ROC)curve of the subjects.The Hosmer-Lemeshow test was used to test the fi t of the model,and the value of the risk prediction model was analyzed by using the ROC curve.Results After univariate analysis,age,gender,BMI,NRS2002 score,operation mode,operation time,intraoperative blood loss,postoperative albumin,postoperative hemoglobin,diabetes mellitus,hypertension,cardiac disease,and hospital stay were not the infl uencing factors of postoperative abdominal infection in gastrointestinal malignant tumors(P>0.05).Postoperative abdominal pain,postoperative abdominal distension,and postoperative calcitoninogen(PCT)were the infl uencing factors of postoperative abdominal cavity infection in gastrointestinal malignant tumors(P<0.05).After multifactorial binary Logistic analysis,postoperative abdominal pain,postoperative abdominal distension,postoperative PCT≥2μg/L,postoperative maximum body temperature≥37.5℃,and postoperative leukocytes≥9.95×10^(9)/L were the risk factors for postoperative abdominal cavity infection of gastrointestinal malignant tumors(P<0.05).The Hosmer-Lemeshow goodness-of-fit test showed thatχ^(2)=0.949,P=0.996.Hosmer-Lemeshow goodness-of-fi t test showed thatχ^(2)=0.949,P=0.996,and the ROC curve showed that the area under the curve(AUC)of the risk model for postoperative abdominal infection of gastrointestinal malignant tumors was 0.880,and the Jordon's index was 0.760,with the sensitivity and specifi city of 78.26%and 97.74%,respectively,and the accuracy for practical application was 95.50%.Conclusion The early warning scale for postoperative abdominal infection of gastrointestinal malignant tumors constructed in this study has a good predictive effect,and can be used as an auxiliary reference for postoperative abdominal infection of gastrointestinal malignant tumors.
作者
王珊
程娟
张楠
郭宇
黄卉
WANG Shan;CHENG Juan;ZHANG Nan;GUO Yu;HUANG Hui(Suqian First People's Hospital,Suqian 223800,China)
出处
《护理实践与研究》
2024年第3期406-413,共8页
Nursing Practice and Research
基金
2021年度宿迁市指导性科技计划项目(编号:202121A)。
关键词
腹腔感染
胃肠恶性肿瘤
风险预警评分表
腹痛
腹胀
Abdominal cavity infection
Gastrointestinal malignant tumors
Risk warning scale
Abdominal pain
Abdominal distension
