甲状腺结节切除术后出现并发症的影响因素分析及Nomogram模型构建

Analysis of factors influencing the occurrence of complications after line excision of thyroid nodules and the con⁃struction of Nomogram model

目的分析甲状腺结节切除术后出现并发症的影响因素,并构建Nomogram模型。方法选取120例甲状腺结节患者为研究对象,根据患者术后是否出现并发症分为并发症组(n=24)和非并发症组(n=96)。观察两组患者的一般资料,分析甲状腺结节切除术后出现并发症的相关因素;并据此构建患者术后出现并发症Nomogram模型,采用决策曲线分析评估Nomogram模型临床效能。结果与非并发症组比较,并发症组患者年龄更大、手术时间更长、术中出血量和引流量更多(t分别=3.95、3.11、7.18、4.51,P均<0.05);年龄、手术时间、术中出血量以及引流量的AUC分别为0.73、0.68、0.87、0.79;手术时间(>90 min)、术中出血量(>70 mL)、引流量(>31 mL/d)是患者术后出现并发症的影响因素(OR分别=1.34、2.31、1.57,P均<0.05);Nomogram模型预测患者术后并发症的风险C-index为0.76;预测患者术后并发症的风险阈值>0.06。结论手术时间(>90 min)、术中出血量(>70 mL)、引流量(>31 mL/d)是患者术后出现并发症的影响因素,且基于变量构建的Nomogram预测模型有较好的准确性和临床实用性。

Objective To analyze the influencing factors of complications after thyroid nodule row resection and con⁃struct the Nomogram model.Methods A total of 120 patients with thyroid nodules were selected as the study subjects,and were divided into the complication group(n=24)and the non-complication group(n=96)according to whether the patients occurred complications after surgery or not.The general data of the patients in the two groups were observed the factors related to the occurrence of complications after resection of thyroid nodules were analyzed,and the Nomogram model was established.Decision curve analysis was used to assess the clinical efficacy of the Nomogram model.Results Compared with the non-complication group,the patients in the complication group were oldor,operation time was longer,intraoperative bleeding volume and drainage volume were larger(t=3.95,3.11,7.18,4.51,P<0.05).The AUCs for the age,operation time,intraoperative bleeding volume,and drainage volume were 0.73,0.68,0.87,0.79.Operation time(>90 min),intraoperative bleeding volume(>70mL),and drainage volume(>31mL/d)were the influencing factors of post⁃operative complications(OR=1.34,2.31,1.57,P<0.05).Nomogram model predicted the risk of postoperative complica⁃tions in patients with a C-index of 0.76,and the type predicted the risk threshold for postoperative complications in pa⁃tients was>0.06.Conclusion Operation time(>90 min),intraoperative bleeding vdume(>70mL),and drainage vol⁃ume(>31mL/d)are the influencing factors of postoperative complications in patients,and the Nomogram prediction mod⁃el constructed on the basis of the variables has good accuracy and clinical utility.