腹腔镜肾部分切除术后并发症预测模型的建立与分析
Journal of Modern Urology（2022）
Abstract
目的 分析影响腹腔镜肾部分切除术后发生并发症的因素,构建列线图预测模型并验证其准确性.方法 回顾性分析2017年9月-2021年7月在中国科学技术大学附属第一医院进行腹腔镜肾部分切除术的300例患者的临床资料,对患者进行3个月的随访,根据患者术后是否出现并发症将其分为并发症组和无并发症组,分析影响腹腔镜肾部分切除术后并发症发生的危险因素,构建风险预测模型,并验证模型的区分度及准确性.结果 本研究中48例(16.00％)患者在腹腔镜肾部分切除术后出现并发症;肿瘤最深处与肾集合系统或肾窦的距离(N值)、热缺血时间≥30 min、合并糖尿病、术中出血量>50 mL为影响腹腔镜肾部分切除术后并发症的独立危险因素(P<0.05);以此为基础构建预测腹腔镜肾部分切除术后并发症的列线图模型,该模型的H-L拟合度检验结果为χ2=6.527,P=0.413.ROC曲线下面积为0.953,敏感性为89.58％,特异性为90.08％,95％C I:0.92～0.97.结论 N值、热缺血时间≥30 min、合并糖尿病、术中出血量>50 mL为影响腹腔镜肾部分切除术后并发症发生的独立危险因素,以此构建的列线图风险预测模型具有较高的区分度及准确性,可为临床早期干预腹腔镜肾部分切除术后并发症的发生提供依据.
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