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老年结直肠癌术后胃肠功能障碍的影响因素及预测模型 被引量:6

Influencing factors and prediction model of postoperative gastrointestinal dysfunction in elderly patients with colorectal cancer
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摘要 目的 探讨老年结直肠癌患者术后胃肠功能障碍的影响因素,建立胃肠功能障碍预测模型。方法 选择2020年2月至2022年2月我院收治的200例老年结直肠癌手术患者作为研究对象,根据术后胃肠功能I-FEED评估结果分为障碍组及非障碍组。通过单因素分析及Logistic回归分析,筛选老年结直肠癌患者术后胃肠功能障碍的影响因素。基于危险因素建立风险预测模型,通过受试者工作特征(ROC)曲线评估模型的预测价值。结果 200例患者中,75例发生术后胃肠功能障碍,发生率为32.50%,年龄大、吸烟史、心血管疾病、术前贫血、术前CA19-9水平高、手术时间长及术前不完全肠梗阻是老年结直肠癌患者术后发生胃肠功能障碍的危险因素(P<0.05),术前营养评分是保护因素(P<0.05)。H-L检验结果显示,预测模型区分度较好。结论 老年结直肠癌术后胃肠功能障碍的影响因素较多,应针对影响因素采取干预措施,以减少术后胃肠功能障碍的发生,改善手术预后。基于上述因素构建的预测模型具有较好的预测价值。 Objective To investigate the influencing factors of postoperative gastrointestinal dysfunction in elderly patients with colorectal cancer,and establish a prediction model of gastrointestinal dysfunction.Methods A total of 200 elderly patients underwent surgery for colorectal cancer in our hospital from February 2020 to February 2022 were selected as the research objects.According to the I-FEED evaluation results of postoperative gastrointestinal function,they were divided into the dysfunction group and the non-dysfunction group.Univariate analysis and Logistic regression analysis were used to screen the influencing factors of postoperative gastrointestinal dysfunction in elderly patients with colorectal cancer.A risk prediction model was constructed based on the risk factors,and the predictive value of the model was evaluated by receiver operating characteristic(ROC)curve.Results Among the 200 patients,75 cases developed postoperative gastrointestinal dysfunction,the incidence rate was 32.50%.Older age,smoking history,cardiovascular disease,preopera⁃tive anemia,high preoperative CA19-9 level,long operation time and incomplete intestinal obstruction were the risk factors for postopera⁃tive gastrointestinal dysfunction in elderly patients with colorectal cancer(P<0.05),and preoperative nutritional score was the protective factor(P<0.05).H-L test results showed that the prediction model had good discrimination.Conclusion There are many influencing factors that affect postoperative gastrointestinal dysfunction in elderly patients with colorectal cancer,and intervention measures should be taken according to the influencing factors to reduce the incidence of postoperative gastrointestinal dysfunction and improve the surgical prognosis.The predictive model constructed based on the above factors has good predictive value.
作者 石丽 夏茂玲 严茜 肖莉 程光林 董馨瑶 SHI Li;XIA Mao-ling;YAN Qian;XIAO Li;CHENG Guang-lin;DONG Xin-yao(Anorectal Department,Guang'an Hospital,West China Hospital of Sichuan University,Guang'an Sichuan 638000,China)
出处 《局解手术学杂志》 2023年第10期906-910,共5页 Journal of Regional Anatomy and Operative Surgery
基金 四川省卫生和计划生育委员会科研项目(18PJ422)。
关键词 老年 结直肠癌 胃肠功能障碍 影响因素 预测模型 elderly colorectal cancer gastrointestinal dysfunction influencing factor predictive model
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