摘要
目的:探讨自发性气胸单孔胸腔镜手术后肺部并发症预测模型的构建。方法:选取2021年5月至2022年5月行单孔胸腔镜手术的106例自发性气胸患者,根据术后是否发生肺部并发症将患者分为并发症组(n=22)与无并发症组(n=84)。对两组患者临床资料进行单因素与多因素分析,筛选出影响术后肺部并发症的危险因素,并构建列线图预测模型。结果:并发症组患者年龄、吸烟史、合并肺部疾病、胸膜粘连严重、肺大疱数量、术后24 h疼痛分级、术中出血量高于无并发症组,术前白蛋白水平低于无并发症组。多因素Logistic回归分析结果显示,年龄≥50岁(OR=1.240,95%CI=1.064~1.445)、合并肺部疾病(OR=26.154,95%CI=1.224~558.648)、胸膜粘连严重(OR=23.289,95%CI=2.940~184.520)、肺大疱数量>2个(OR=2.878,95%CI=1.787~4.633)是影响术后肺部并发症的独立危险因素(P<0.05)。根据以上危险因素建立预测模型预测术后肺部并发症的受试者工作特征曲线下面积为0.82(95%CI=0.756~0.874),敏感度与特异度分别为82.33%与65.47%。结论:年龄、合并肺部疾病、胸膜粘连严重、肺大疱数量是影响自发性气胸单孔胸腔镜手术后肺部并发症的独立危险因素,根据其构建的列线图预测模型对术后肺部并发症的发生风险具有较好的预测价值。
Objective:To investigate the construction of prediction model of pulmonary complications in patients with spontaneous pneumothorax after single port thoracoscopic surgery.Methods:From May 2021 to May 2022,106 patients with spontaneous pneumothorax who had undergone single port thoracoscopic surgery were selected and divided into complication group(n=22)and noncomplication group(n=84)according to the occurrence of postoperative lung complications.The clinical data of the patients in two groups were analyzed by univariate and multivariate analysis,and the risk factors affecting postoperative pulmonary complications were screened out,and the prediction model was constructed by nomogram.Results:Age,smoking history,pulmonary disease,severe pleural adhesion,number of pulmonary bullae,pain grade 24 h after surgery,and intraoperative blood loss in the complication group were higher than those in the non-complication group,preoperative albumin level was lower.Multivariate logistic regression analysis showed that age≥50 years old(OR=1.240,95%CI=1.064~1.445),pulmonary disease(OR=26.154,95%CI=1.224~558.648),severe pleural adhesion(OR=23.289,95%CI=2.940~184.520)and the number of pulmonary bullae>2(OR=2.878,95%CI=1.787~4.633)were independent risk factors for postoperative pulmonary complications(P<0.05).The area under receiver operating characteristic curve of the predictive model established based on the above risk factors for predicting postoperative pulmonary complications was 0.82(95%CI=0.756~0.874),the sensitivity and specificity was 82.33%and 65.47%,respectively.Conclusions:Age,pulmonary disease,severe pleural adhesion,and the number of pulmonary bullae are independent risk factors for pulmonary complications after single port thoracoscopic spontaneous pneumothorax operation.The prediction model based on these factors has good predictive value for predicting the risk of postoperative pulmonary complications.
作者
王永平
王辉
郑翔
闻作川
田浩
陈鹏
刘冠群
WANG Yongping;WANG Hui;ZHENG Xiang(Department of Extrathoracic Vascular Surgery,Daxing District People's Hospital,Beijing 102600,China)
出处
《腹腔镜外科杂志》
2024年第5期321-325,共5页
Journal of Laparoscopic Surgery
关键词
自发性气胸
胸腔镜检查
单孔
术后肺部并发症
预测模型
Spontaneous pneumothorax
Thoracoscopy
Single port
Postoperative pulmonary complications
Prediction model
