%0 Journal Article
%T 早期胃癌患者ESD术后并发肺炎相关因素分析及风险模型预测
%A 刘晓燕
%A 汤海涛
%A 潘宏年
%A 王修中
%J 肿瘤防治研究
%D 2019
%R 10.3971/j.issn.1000-8578.2019.19.0337
%X 摘要 目的 探讨早期胃癌患者内镜黏膜下剥离（ESD）术后并发肺炎的相关因素及风险模型预测。方法 选取2016年5月—2019年2月六安市人民医院171例接受治疗的早期胃癌患者，所有患者均接受ESD术，采用Logistic回归分析筛选早期胃癌患者ESD术后并发肺炎的独立危险因素。根据筛选出的独立危险因素建立列线图预测模型，并对模型的准确度及预测性进行验证。结果 高血脂（OR=0.216, 95%CI: 0.052~1.274）、抗菌药物使用情况（OR=12.591, 95%CI: 3.242~48.899）、是否入住CU（OR=12.591, 95%CI: 0.015~0.281）、是否吞咽障碍（OR=0.217, 95%CI: 0.048~0.972）、浸润深度（OR=0.12, 95%CI: 0.025~0.572）、口腔护理（OR=8.976, 95%CI: 2.291~35.16）及留置胃管（OR=3.906, 95%CI: 1.097~13.907）为ESD术后并发肺炎的独立危险因素，基于筛选出的7项独立危险因素，建立预测ESD术后并发肺炎风险的列线图模型。通过对该模型进行验证表明：预测值和观察值基本一致，说明本研究的列线图预测模型具有较好的预测能力，同时使用Bootstrap部验证法对ESD术后并发肺炎的列线图模型进行验证，C-index指数高达0.937（95%CI: 0.929~0.945），说明列线图模型有良好的精准度和区分度。 结论 对行ESD术后的早期胃癌患者及时考虑高血脂、抗菌药物使用情况、是否入住ICU、是否吞咽障碍、浸润深度、口腔护理及留置胃管等因素综合评估ESD术后肺炎的发生率，能提高对早期胃癌患者ESD术后并发肺炎的诊断效能
%K 早期胃癌
%K 内镜黏膜下剥离
%K 肺炎
%K 风险模型预测
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%U http://www.zlfzyj.com/CN/abstract/abstract9494.shtml