摘要
目的探讨肿瘤患者静脉高压注射碘对比剂外渗风险因素, 构建对比剂外渗列线图模型, 为检查前发现外渗高危因素提供参考依据。方法采用回顾性病例对照研究方法, 随机抽样法选取2021年9月至2023年9月在山西医科大学第二医院、山西省人民医院、山西省肿瘤医院行CT增强检查发生碘对比剂外渗的肿瘤患者202例为病例组, 并随机选取同期在上述3所医院行CT增强检查的无碘对比剂外渗肿瘤患者202例为对照组, 采用多因素二元Logistic回归分析肿瘤患者碘对比剂外渗的独立危险因素, 通过R4.3.1统计软件建立列线图预测模型, 并利用受试者工作特征(ROC)曲线、校准曲线及Hosmer-Lemeshow拟合优度检验评估模型预测效能。结果最终纳入404例肿瘤患者。病例组患者男97例, 女105例, 年龄30 ~ 88(62.97 ± 0.91)岁;对照组患者男123例, 女79例, 年龄31 ~ 85(61.38 ± 0.73)岁。多因素二元Logistic回归分析显示, 年龄、性别、注射速率、对比剂浓度、对比剂渗透浓度、长期化疗及护士工作年限为肿瘤患者静脉高压注射碘对比剂外渗的独立危险因素(OR值为0.306 ~ 6.365, 均P<0.05);列线图模型预测外渗风险ROC曲线下面积为0.814(95% CI 0.714 ~ 0.875), 特异度为78.1%, 敏感度为70.2%, 校准曲线斜率接近1, Hosmer-Lemeshow拟合优度检验χ2 = 11.47, P>0.05。结论本研究构建的列线图模型能较为准确地预测肿瘤患者发生碘对比剂外渗的风险, 为检查前发现外渗风险因素提供借鉴与参考。
Objective To investigate the risk factors of iodinated contrast agent extravasation in tumor patients with intravenous high pressure injection,and to develop a nomogram model of contrast agent extravasation,so as to provide reference for the detection of extravasation risk factors before examination.Methods A retrospective case-control study was used in this study.Two hundred and two tumor patients with iodinatedcontrast agent extravasation who underwent enhanced CT examination in the Second Hospital of Shanxi Medical University,Shanxi People's Hospital and Shanxi tumor Hospital from September 2021 to September 2023 were selected by random sampling method as the case group,and 202 tumor patients without iodinated contrast agent extravasation who underwent enhanced CT examination in the above 3 hospitals during the same period were randomly selected as the control group.Multivariate Logistic regression was used to analyze the independent risk factors of iodinated contrast agent extravasation and a nomogram prediction model was established by R4.3.1 statistical software.The receiver operating characteristic(ROC)curve,calibration curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the predictive efficiency of the model.Results A total of 404 tumor patients were included in this study.There were 97 males and 105 females in the case group,aged 30-88(62.97±0.91)years old;and 123 males and 79 females in the control group,aged 31-85(61.38±0.73)years old.Multivariate Logistic regression analysis showed that age,sex,injection rate,contrast agent concentration,contrast osmotic concentration,long-term chemotherapy and nurses'working years were independent risk factors for iodinated contrast agent extravasation(OR values were 0.306-6.365,all P<0.05).The area under the ROC curve predicted by the nomogram model was 0.814(95% CI 0.714-0.875),the specificity was 78.1%,the sensitivity was 70.2%,the slope of calibration curve was close to 1,and the Hosmer-Lemeshow goodness of fit test X^(2)=11.47,P>0.05.Conclusions The nomogram model established in this study can accurately predict the risk of iodinated contrast agent extravasation in tumor patients,and provide a reference for the detection of high-risk factors of extravasation before examination.
作者
吕婧
赵佳妮
张月英
Lyu Jing;Zhao Jiani;Zhang Yueying(School of Nursing,Shanxi Medical University,Taiyuan 030001,China;Department of Imaging,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《中国实用护理杂志》
2024年第20期1528-1534,共7页
Chinese Journal of Practical Nursing
基金
山西省重点研发计划项目(201903D321192)。
关键词
肿瘤
列线图
碘对比剂
CT增强检查
静脉外渗
风险预测模型
eoplasms
Nomograms
lodinated contrast agent
Contrast-enhanced CT
Extravasation
Risk prediction model
