摘要
目的 探讨直肠癌术后吻合口瘘风险列线图的构建与护理实践。方法 回顾性分析2022年5月至2025年5月在无锡市人民医院手术室进行直肠癌根治术治疗的106例直肠癌患者临床资料,根据其是否发生吻合口瘘分为吻合口瘘组(21例)和非吻合口瘘组(85例)。收集2组的临床资料,采用单因素和多因素分析对术后发生吻合口瘘风险因素进行筛选,构建列线图预测模型并进行应用验证。结果 单因素分析结果示,性别、体重指数(BMI)、吸烟史、肿瘤距肛门距离、营养风险筛查2002(NRS 2002)评分、血红蛋白、术中出血量、手术时间及卡式评分均与直肠癌术后发生吻合口瘘有关(P均<0.05)。多因素Logistic分析结果示,NRS 2002评分>3分、BMI≥24 kg/m^(2)、血红蛋白<120 g/L、肿瘤距肛门距离≤10 cm均是直肠癌术后发生吻合口瘘的风险因素(P均<0.05)。直肠癌术后发生吻合口瘘列线图的曲线下面积为0.758 [95%CI(0.688~0.829)]。结论 本研究构建的列线图模型预测效能较好,有助于早期识别高风险患者并优化护理策略,降低直肠癌术后吻合口瘘的发生风险。
Objective To develop a nomogram of anastomotic leakage risk after rectal cancer surgery and to explore its application in nursing practice.Methods A retrospective analysis was conducted on the clinical data of 106 patients who underwent radical resection of rectal cancer in the operating room of Wuxi People's Hospital between May 2022 and May 2025.Based on the status of anastomotic leakage,the patients were divided into an anastomotic leakage group(n=21)and a nonanastomotic leakage group(n=85).Clinical data from the two groups were collected,and univariate and multivariate analyses were used to identify risk factors for postoperative anastomotic leakage.A nomogram prediction model was then developed and subjected to application validation.Results Univariate analysis showed that gender,body mass index(BMI),smoking history,distance from tumor to anus,Nutritional Risk Screening 2002(NRS 2002)score,hemoglobin level,intraoperative blood loss,duration of surgery,and Karnofsky Performance Status(KPS)score were associated with the occurrence of anastomotic leakage after rectal cancer surgery(P<0.05).Multivariate logistic regression analysis revealed that an NRS 2002 score>3,BMI≥24 kg/m^(2),hemoglobin<120 g/L,and distance from tumor to anus≤10 cm were risk factors for anastomotic leakage after rectal cancer surgery(P<0.05).The area under the curve(AUC)of the nomogram of anastomotic leakage after rectal cancer surgery was 0.758(95%CI:0.688~0.829).Conclusion The nomogram model developed in this study demonstrates good predictive performance,which is conducive to the early identification of high-risk patients and the optimization of nursing strategies,as well as reducing the risk of anastomotic leakage after rectal cancer surgery.
作者
桑燕
周晓红
曹慧文
SANG Yan;ZHOU Xiaohong;CAO Huiwen(The Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi Medical Center,Nanjing Medical University,Wuxi People's Hospital,Wuxi,Jiangsu,214000,China)
出处
《中西医结合护理(中英文)》
2025年第10期69-72,共4页
Journal of Clinical Nursing in Practice
关键词
直肠癌根治术
吻合口瘘
列线图
护理方法
radical resection of rectal cancer
anastomotic leakage
nomogram
nursing method
