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
DOI: 10.3971/j.issn.1000-8578.2019.19.0337
Keywords: 早期胃癌,内镜黏膜下剥离,肺炎,风险模型预测,Influence of Different Radio-chemotherapy Modes for Incidence of Radiation Pneumonitis in Patients with Lung Cancer,Recognition of Laparoscopic Local Gastrectomy Combined with Lymphatic Basin Dissection on Early Gastric Cancer,Value of 18F-FDG Distribution for Differential Diagnosis of High Metabolic Lung Lesions,Influence Factors for Radiation Pneumonitis in Stage Ⅲ Non-small Cell Lung Cancer Patients Treated with Three-dimensional Conformal Radiotherapy,Predictors of Pulmonary LesionInducedby Three Dimensional Conformal Radiotherapy Combined with Ｃhemotherapy of NP forⅢStage Non-small Cell Lung Cancer,Expression of MMP-9 and E-cadherin in Early Gastric Carcinoma and Metastasic Lymph Node,Detection and Evaluation of Serum Proteomic Patterns by SELDI-TOF-MS in Early Gastric Cancer,Quantif ication of O-Phospho-L-tyrosine Protein( PTPr) in the Sera of Respiratory Patients,Clinical Pathology Analysis of 15 Cases Pulmonary Inflammatory Pseudoma,The diagnosis and surgical treatment of inflammatory pseudotumor of the lung,The Analysis of 56 Cases of Early Gastric Cancer Performed Mode-Ⅱ Radical Operation Combined with the Subtotal Excision of Curvatura Veutriculi Minor
Abstract:
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
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