[1]党新臣,钱 河,赵宝生.食管癌患者术后肺部感染危险因素分析[J].新乡医学院学报,2020,37(10):950-954.[doi:10.7683/xxyxyxb.2020.10.011]
 DANG Xinchen,QIAN He,ZHAO Baosheng.Risk factors of postoperative pulmonary infection in patients with esophageal cancer[J].Journal of Xinxiang Medical University,2020,37(10):950-954.[doi:10.7683/xxyxyxb.2020.10.011]
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食管癌患者术后肺部感染危险因素分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年10
页码:
950-954
栏目:
临床研究
出版日期:
2020-10-05

文章信息/Info

Title:
Risk factors of postoperative pulmonary infection in patients with esophageal cancer
作者:
党新臣钱 河赵宝生
(新乡医学院第一附属医院胸外科,河南 卫辉 453100)
Author(s):
DANG XinchenQIAN HeZHAO Baosheng
(Department of Thoracic Surgery,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)
关键词:
食管癌肺部感染危险因素列线图
Keywords:
esophageal cancerpulmonary infectionrisk factorsnomogram
分类号:
R735.1
DOI:
10.7683/xxyxyxb.2020.10.011
文献标志码:
A
摘要:
目的 探讨食管癌患者术后肺部感染的危险因素,建立列线图风险预测模型,为临床制定干预措施提供参考依据。方法 回顾性分析2014年9月至2019年5月于新乡医学院第一附属医院胸外科行食管癌手术644例患者的临床资料,采用单因素和多因素logistic回归分析食管癌患者术后并发肺部感染的危险因素,并建立列线图风险预测模型,以一致性指数(C-index)、校准曲线评估模型精准度并进行预测性验证。结果 644例食管癌患者术后并发肺部感染率为29.19%(188/644)。单因素分析结果显示,食管癌患者术后并发肺部感染与年龄、体质量指数(BMI)、肿瘤部位、肺部相关疾病史(哮喘、肺气肿、支气管炎)、糖尿病、吸烟史、手术方式及手术时间有关(P<0.05),与性别、高血压、饮酒史、第1秒用力呼气量占用力肺活量的比例、术前外周血白细胞计数、美国麻醉师协会评分、术中出血量及术后营养方式无关(P>0.05)。Logistic回归分析结果显示,年龄、BMI、肺部相关疾病史、糖尿病、吸烟史、手术时间、肿瘤部位以及手术方式是食管癌患者术后并发肺部感染的危险因素(P<0.05)。列线图风险预测模型经C-index、校准曲线验证预测值和观察值基本一致(C-index=0.782),具有较好的预测能力。结论 年龄、BMI、肺部相关疾病史、糖尿病、吸烟史、手术时间、肿瘤部位以及手术方式是食管癌患者术后并发肺部感染的危险因素。
Abstract:
Objective To explore the risk factors of postoperative pulmonary infection in patients with esophageal cancer,and establish a risk prediction model for providing a reference for clinical interventions.Methods The clinical data of 644 patients with esophageal cancer who were admitted to the Department of Thoracic Surgery,the First Affiliated Hospital of Xinxiang Medical University from September 2014 to May 2019 were retrospectively analyzed.The risk factors of pulmonary infection were analyzed by using univariate and logistic regression analysis,and the risk prediction model of the nomogram was established.The accuracy and the predictive value of the model was evaluated with consistency index (C-index) and calibrate curves.Results The pulmonary infection rate of 644 patients with esophageal cancer after surgery was 29.19% (188/644).Univariate analysis showed that the pulmonary infection of patients with esophageal cancer after surgery was associated with age,body mass index(BMI),tumor site,history of lung related diseases(asthma,emphysema,bronchitis),diabetes,smoking history,operation model and operation time(P<0.05);and it was not associated with the gender,hypertension,drinking history,the ratio of the forced expiratory volume in the first second to the forced vital capacity,white blood cell count before operation,American Society of Anesthesiologists score,intraoperative blood loss,and postoperative nutrition formula (P>0.05).Logistic regression analysis showed that the age,BMI,history of lung related diseases,diabetes,smoking history,operation time,tumor location and operation model were risk factors of pulmonary infection of patients with esophageal cancer after operation (P<0.05).The predicted value and the observed value of the nomogram model were basically the same (C-index=0.782),and it had good predictive ability.Conclusion Age,BMI,history of lung related diseases,diabetes,smoking history,operation time,tumor location,and operation method are risk factors of pulmonary infection of esophageal cancer patients after esophageal cancer surgery.

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更新日期/Last Update: 2020-10-05