胸腔镜下肺癌根治患者术中低体温风险预警模型构建与验证

Construction and validation of a risk warning model for intraoperative hypothermia in patients undergoing thoracoscopic radical resection of lung cancer

目的探讨胸腔镜下肺癌根治患者术中低体温的影响因素,基于列线图建立胸腔镜下肺癌根治患者术中低体温风险列线图并验证。方法回顾性选取我院于2022年12月至2023年12月行胸腔镜下肺癌根治术患者189例,根据患者术中是否低体温将患者分为低体温组(85例)和非低体温组(104例)。采用多因素Logistic回归法分析胸腔镜下肺癌根治患者术中低体温的危险因素,构建术中低体温的风险图并进行验证。结果通过多因素Logistic回归分析,结果显示,患者年龄大、体质指数(BMI)偏高、麻醉时间>2.5 h、手术时间>2 h、输液总量>1600 ml和入室体温低均为胸腔镜下肺癌根治患者术中低体温的独立危险因素(P<0.05)。对列线图进行验证,受试者工作特征曲线(ROC)曲线下面积(AUC)(95%CI)为0.885(0.839,0.931),区分度良好,该模型的最佳临界值为0.638,灵敏度为85.9%,特异度为77.9%。校准曲线的理论值和实际值有较好的一致性。结论胸腔镜下肺癌根治患者术中低体温风险列线图具有较好的预测价值,医护人员可根据胸腔镜下肺癌根治患者术中低体温风险预测模型制定针对性干预措施。

Objective To explore the influencing factors of intraoperative hypothermia in patients undergoing thoracoscopic radical resection of lung cancer,and to establish a column chart based on the risk of intraoperative hypothermia in patients undergoing thoracoscopic radical resection of lung cancer and verify it.Methods A retrospective selection was conducted on 189 patients who underwent thoracoscopic radical resection of lung cancer in our hospital from December 2022 to December 2023.Patients were divided into a hypothermia group(85 cases)and a non-hypothermia group(104 cases)based on whether they had hypothermia during surgery.The multiple logistic regression method was used to analyze the risk factors of intraoperative hypothermia in patients undergoing thoracoscopic radical resection of lung cancer,constructing a risk map of intraoperative hypothermia and conducting validation.Results Through multiple logistic regression analysis,the results showed that older patients,High body mass index(BMI),anesthesia time>2.5 hours,surgery time>2 hours,total infusion volume>1600 ml,and low entry temperature were all independent risk factors for intraoperative hypothermia in patients undergoing thoracoscopic radical resection of lung cancer(P<0.05).Verify the column chart,the area under the receiver operator characteristic curve(ROC)(95%CI)was 0.885(0.839,0.931),with good discrimination.The optimal critical value of the model was 0.638,sensitivity was 85.9%,and specificity was 77.9%.The theoretical and actual values of the calibration curve had good consistency.Conclusion The column chart of intraoperative hypothermia risk in thoracoscopic radical lung cancer patients has good predictive value,and medical staff can develop targeted intervention measures based on the intraoperative hypothermia risk prediction model of thoracoscopic radical lung cancer patients.