| 冯贵生,艾正友,付林.胃癌根治术后合并肺部感染的风险模型构建及奥曲肽预防作用[J].安徽医药,2023,27(2):350-353. |
| 胃癌根治术后合并肺部感染的风险模型构建及奥曲肽预防作用 |
| Establishment of a risk model for pulmonary coinfection after radical surgery for gastric cancer and the preventive effect of octreotide |
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| DOI：10.3969/j.issn.1009-6469.2023.02.031 |
| 中文关键词: 呼吸道感染 胃切除术 胃肿瘤 危险因素 奥曲肽 |
| 英文关键词: Respiratory tract infections Gastrectomy Stomach neoplasms Risk factors Octreotide |
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| 中文摘要: |
| 目的探讨胃癌根治病人术后合并肺部感染的风险模型构建及奥曲肽的预防作用。方法选取简阳市人民医院 2015年 5月至 2019年 5月收治的行胃癌根治术( RG)的病人 280例作为研究对象，回顾所有病人的临床资料，通过多因素 logis-tic回归分析筛选出影响 RG病人合并肺部感染的独立危险因素，利用 R软件建立相应的列线图模型，并对模型进行验证；初步评估给予奥曲肽治疗后胃癌病人并发症发生情况。结果年龄 ≥60岁、术前白蛋白 <35 g/L、手术时间 ≥3 h、病理分期为 Ⅲ~Ⅳ期、留置胃管为影响 RG病人合并肺部感染的独立危险因素(P<0.05)。同时对筛选出独立危险因素建立列线图进行验证，结果显示建模集和验证集的 C-index指数分别为 0.82，95%CI:(0.68，0.96)和 0.81，95%CI:(0.68，0.94)，两组的校正曲线均与标准曲线拟合较好， ROC曲线下面积( AUC)分别为 0.82和 0.81，证明本次模型具有良好的预测精准度。给予奥曲肽治疗后，观察组病人发生不良反应 9例，明显低于对照组的 25例( P<0.05)。结论年龄、术前白蛋白、手术时间、病理分期、留置胃管为影响 RG病人合并肺部感染的独立危险因素，医护人员可根据本研究建立的列线图模型在术前针对不同个体给予针对性干预措施，以降低肺部感染的风险。奥曲肽可明显降低 RG术后肺部感染，减少术后各类并发症的发生率。 |
| 英文摘要: |
| Objective To investigate the construction of a risk model for postoperative pulmonary coinfection in patients with radi-cal gastric cancer and the preventive effect of octreotide.Methods A total of 280 patients who underwent radical gastrecyectomy (RG)for gastric cancer admitted to Jianyang People's Hospital from May 2015 to May 2019 were selected as the study subjects. The clinicaldata of all patients were reviewed, and independent risk factors affecting the pulmonary coinfection in RG patients were screened bymultivariate logistic regression analysis. The corresponding column graph model was established by R software, and the model was vali-dated. Preliminary assessment of the occurrence of complications in patients with gastric cancer after administration of octreotide.Re. sults Age ≥60 years, preoperative albumin <35 g/L, operative time ≥3 h, pathological stage Ⅲ -Ⅳ, and and indwelling gastric tube were independent risk factors for pulmonary infection in patients with RG (P<0.05). The independent risk factors were also screened to create column graphs for validation, and the results showed that the C-index indices of the modeling set and validation set were 0.82, 95%CI:(0.68,0.96) and 0.81, 95%CI:(0.68,0.94), respectively. The correction curves of the two groups fit well with the standard curve,and the areas under the ROC curve (AUCs) were 0.82 and 0.81, respectively, which proved that the present model had good predictiveaccuracy. After administration of octreotide, 9 cases of adverse reactions occurred in patients in the observation group, which was signif-icantly lower than the 25 cases in the control group (P<0.05).Conclusions Age, preoperative albumin, operative time, pathologicalstage and indwelling gastric tube were independent risk factors affecting the coinfection of pulmonary infection in RG patients, andhealthcare professionals can provide targeted interventions for different individuals preoperatively to reduce the risk of pulmonary infec-tion according to the columnar graph model established in this study. Octreotide can significantly reduce postoperative pulmonary infec-tions in RG and reduce the incidence of various postoperative complications. |
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