在接受PCNL治疗的MetS患者中预测术后SIRS风险因素
Song Wei1, Shu-Hao Li1, Bo-Ran Lv1
1Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou, 510630, Guangdong, People's Republic of China.
Urolithiasis
|July 5, 2025
概括
这项研究确定了在代谢综合征 (MetS) 患者的皮肤通瘤切除术 (PCNL) 后发生系统性炎症反应综合征 (SIRS) 的关键手术前危险因素. 为了更好地评估风险和个性化护理,开发了一种预测性名录.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术瘤学手术瘤学
背景情况:
- 代谢综合征 (MetS) 与手术风险增加有关.
- 系统性炎症反应综合征 (SIRS) 是皮肤透神经解剖术 (PCNL) 后的一种潜在并发症.
- 在接受PCNL的METS患者中SIRS的准确手术前风险分层对于外科手术期间的管理至关重要.
研究的目的:
- 在接受PCNL的MetS患者中确定术后SIRS的独立术前风险因素.
- 开发和验证用于个性化SIRS风险分层的预测名录.
- 为改善这些患者的早期干预和个性化术后护理.
主要方法:
- 对接受PCNL的245名MetS患者的回顾性分析.
- 使用最小绝对收缩和选择运算符 (LASSO) 回归来进行预测器选择.
- 采用单变量和多变量后勤回归,ROC曲线,校准图和决策曲线分析 (DCA) 来进行模型开发和验证.
主要成果:
- 确定了SIRS的五个独立预测因素:石块密度的标准偏差较高,脏膜厚度降低,周脂肪增加和鹿角结石.
- 开发的名图表显示出良好的区分能力 (AUC训练:0.888,AUC验证:0.882).
- 诺米图表显示了良好的校准和临床实用性,这是DCA证实的.
结论:
- 已开发出一种可靠的手术前诺基图,用于在接受PCNL的METS患者中进行SIRS风险分层.
- 这种工具可以帮助临床医生识别高风险患者进行早期干预.
- 基于这种风险评估,可以加强个性化的外科外科手术期间管理策略.
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