在腹腔镜减肥手术后的病房内预测术后恶心和吐的诺莫图
Xiahao Ding1,2, Jinxing Che1,3, Siyang Xu1,4
1Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Surgical endoscopy
|October 23, 2023
概括
一种新的预测模型有效地识别了腹腔镜腹手术 (LBS) 后患术后恶心和吐 (PONV) 风险的患者. 该工具有助于制定针对PNV预防的个性化预防策略.
科学领域:
- 腹部外科 腹部外科
- 麻醉学 麻醉学
- 临床预测模型临床预测模型
背景情况:
- 手术后恶心和吐 (PONV) 是腹腔镜减肥手术 (LBS) 后的频繁且显著的并发症.
- 目前的管理策略缺乏在LBS患者中对PONV的综合预测模型.
- 对于LBS,需要有效的PONV预防和治疗方案.
研究的目的:
- 开发和验证在接受LBS的患者中对PONV的预测模型.
- 为了确定LBS后PONV的独立预测因子.
- 在接受LBS的糖尿病患者中探索PONV的特定风险因素.
主要方法:
- 进行了一项随机对照试验,涉及334名LBS患者.
- 数据被分为培训 (70%) 和验证 (30%) 队列.
- 最小绝对收缩和选择运算符 (LASSO) 回归和多变量后勤回归被用来构建一个名ogram预测模型.
主要成果:
- 诺米图表表现出强大的预测性能,培训队列中的AUC为0.850,验证队列中的AUC为0.847.
- 校准图表证实了预测和观察到的PONV发病率之间的良好一致.
- 对于糖尿病患者来说,手术类型,sugammadex使用和胰岛素水平预测了PONV (AUC 0.802).
结论:
- 一个经过验证的诺莫格拉姆模型可以预测LBS患者的PONV风险.
- 该模型为个性化的PONV预防方案提供了一个精确的工具.
- 对糖尿病患者的特定风险因素分析提高了针对性的PONV管理.
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