摘要
目的分析老年糖尿病胆囊切除术患者术后切口感染的相关易感因素并构建相应的列线图模型。方法回顾性选取2022年4月至2024年3月于本院行胆囊切除术患者495例作为研究对象,以7∶3的比例分为模型样本(346例)和验证样本(149例)。2样本均根据是否发生术后切口感染分为感染组和未感染组。收集其手术前后相关数据,对其进行危险因素分析并构建风险列线图模型。结果其中感染组48例(13.87%),未感染组298例(86.13%)。多因素分析结果显示,两组患者吸烟、术前行内镜逆行性胰胆管造影术(ERCP)、手术时间、术中胆囊破裂、胆囊结石、胆囊周边积液、白细胞计数、术中输血、类固醇药物、手术切口及ASA分级为患者术后切口感染的独立影响因素(P<0.05),以此构建风险列线图模型。其受试者特征曲线下面积为0.930(95%CI:0.894~0.967),敏感度为0.813,特异度为0.909,Youden指数为0.722。Hosemer-Lemeshow检验显示χ^(2)=5.146,P=0.742。结论老年糖尿病胆囊切除术患者术后切口感染列线图模型的预测效能良好,医护人员可通过患者吸烟情况、是否术前行ERCP、手术切口及ASA分级等指标判断患者术后切口感染的风险并采取针对性干预措施。
Objective To construct a nomogram model of urinary tract infection in patients with urinary incontinence af-ter laparoscopic radical prostatectomy.Methods We retrospectively selected 495 patients who underwent cholecystectomy in our hospital from April 2022 to March 2024 as the research subjects.They were divided into model samples(346 cases)and valida-tion samples(149 cases)at a ratio of 7∶3.The two samples were divided into the infected group and the uninfected group accord-ing to whether urinary tract infection occurred.We collected relevant data before and after the surgery,analyzed the risk factors,and constructed the risk nomogram model.Results There were 48 cases(13.87%)in the infected group and 298 cases(86.13%)in the uninfected group.Multivariate analysis showed that smoking,ERCP before surgery,the surgery time,intraop-erative gallbladder rupture,gallstone,perigallbladder effusion,white blood cell count,intraoperative blood transfusion,steroid drugs,surgical incision and ASA grade were independent influencing factors of postoperative incision infection in both groups(all P<0.05).On this basis,the nomogram model was established.The area under the receiver operating characteristic curve for the subjects was 0.930,with a 95%confidence interval 0.894-0.967.The sensitivity was 0.813,the specificity was 0.909,and the Youden index was 0.722.The Hosmer-Lemeshow test showed thatχ^(2)=5.146,P=0.742.Conclusion The nomogram model of postoperative incision infection in elderly patients with diabetic cholecystectomy has good predictive efficacy.Medical staff can judge the risk of postoperative incision infection by smoking status,preoperative ERCP,surgical incision and ASA clas-sification,and take targeted intervention measures.
作者
刘孝玲
左玲
尹晓东
滕卓艳
Liu Xiaoling;Zuo Ling;Yin Xiaodong;Teng Zhuoyan(Department of Central Sterile Supply,People′s Liberation Army Joint Logistic Support Force 903th Hospital,Hangzhou 310013,China;Department of General Surgery,People′s Liberation Army Joint Logistic Support Force 903th Hospital,Hangzhou 310013,China)
出处
《中国医院统计》
2026年第1期14-20,共7页
Chinese Journal of Hospital Statistics
关键词
糖尿病
老年患者
胆囊切除术
术后切口感染
列线图
diabetes
elderly patient
cholecystectomy
postoperative incision infection
nomograph
