首页|腹腔镜卵巢囊肿剥除术后下肢深静脉血栓形成回归预测模型建立及评价

腹腔镜卵巢囊肿剥除术后下肢深静脉血栓形成回归预测模型建立及评价

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目的:分析腹腔镜卵巢囊肿剥除术后下肢深静脉血栓形成(DVT)的影响因素,确定下肢DVT风险指标,建立回归预测模型并对进行评价.方法:应用便利抽样法,选择2021年6月-2023年2月医院行腹腔镜卵巢囊肿剥除术患者292例临床资料,统计术后下肢DVT发生情况.采用单因素分析与多因素logistic回归分析术后出现下肢DVT的独立危险因素,构建回归预测模型,采用Hosmer-Lemeshow(H-L)检验评估模型拟合优度,受试者工作特征曲线(ROC)检验模型预测效能.结果:292例患者术后出现下肢DVT 21例(7.2%),logistic回归分析显示,高血压史、手术时间长、术中气腹压高、术后1 d血D-二聚体和凝血因子Ⅷ水平升高均为腹腔镜卵巢囊肿剥除术后出现下肢DVT的独立危险因素(均P<0.05).依据上述独立危险因素建立logistic回归预测模型,H-L检验显示P=0.847,提示模型构建有效.ROC曲线显示,模型预测腹腔镜卵巢囊肿剥除术后出现下肢DVT的曲线下面积为0.764,预测效能中等.约登指数取最大值0.448时,模型预测的敏感度76.2%,特异度为68.6%.结论:本研究建立的回归预测模型可为腹腔镜卵巢囊肿剥除术后下肢DVT识别提供参考依据,可能有助于患者术后个性化DVT预防管理.
Establish and evaluation of a regression prediction model of the lower extremity deep vein thrombosis after laparoscopic o-varian cystectomy
Objective:To investigate the influencing factors of the lower extremity deep vein thrombosis(DVT)of pa-tients after laparoscopic ovarian cystectomy,to identify the risk indicators of DVT,and to establish and evaluate a re-gression prediction model of DVT of the patients.Methods:The clinical data of 292 patients who underwent laparo-scopic ovarian cystectomy from June 2021 to February 2023 were selected as research subjects by convenience sam-pling.The postoperative lower extremity DVT occurrence of the patients were statistically analyzed.Univariate analysis and multivariate logistic regression analysis were used to explore the independent risk factors of the lower extremity DVT of the patients after laparoscopic ovarian cystectomy.A regression prediction model was established,and its goodness of fit of the model was evaluated by Hosmer Lemeshow(H-L)test.The predictive efficiency of the model for DVT was assessed by receiver operating characteristic(ROC)curve.Results:In 292 patients,there were 21(7.2%)cases with lower limb DVT.Logistic regression analysis showed that the history of high blood pressure,the long oper-ative time,the high intraoperative pneumoperitoneum pressure,and the increase of the levels of the D dimers and blood coagulation factor Ⅷ in the postoperative 1st day of the patients after laparoscopic ovarian cystectomy were all the independent risk factors of their lower extremity DVT occurrence(all P<0.05).Based on these independent risk factors,a logistic regression prediction model was established,and H-L test showed that P=0.847,and which sug-gested that the model was efficacy.ROC curve showed that the area under the curve of the model for predicting the lower extremity DVT of the patients after laparoscopic ovarian cystectomy was 0.764,and the prediction efficiency of which was medium.When the maximum Youden index was 0.448,the sensitivity and the specificity of the model for predicting the lower extremity DVT of the patients after laparoscopic ovarian cystectomy were 76.2%and 68.6%.Con-clusion:The regression prediction model established in this study can provide the evidences for identifying the lower extremity DVT of the patients after laparoscopic ovarian cystectomy,which may assist the personalized postoperative DVT prevention management of the patients.

Laparoscopic ovarian cystectomyLower extremity deep vein thrombosisInfluencing factorsPredictive model

邱文娟、张敏、王美

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安徽省临泉县人民医院(236400)

腹腔镜卵巢囊肿剥除术 下肢深静脉血栓形成 影响因素 预测模型

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(2)
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