用于预测皮肤内切除术中术后大出血的诺莫грам:一项回顾性研究
Yifan Wu1, Jue Gong1, Chenyu Qiu1
1Department of Urology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
European urology open science
|August 4, 2025
概括
这项研究开发了一种名图,用于预测皮肤穿神经切除术 (PCNL) 后的主要出血风险. 该工具确定了关键的风险因素,帮助外科医生进行手术前评估,并提高了患者的安全性.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 穿皮骨切除术 (PCNL) 是对结石的一种常见手术.
- 手术后严重出血是PCNL后的一个重大并发症.
- 准确的风险分层对于患者管理和手术规划至关重要.
研究的目的:
- 开发和验证PCNL后大出血的预测性名谱.
- 为了确定与术后出血相关的独立风险因素.
- 提供一个工具,以加强PCNL患者的手术前风险评估.
主要方法:
- 对493名接受单边PCNL治疗的患者进行了回顾性分析.
- 使用最少绝对收缩和选择运算符 (LASSO) 和多变量后勤回归开发名图.
- 时间划分为培训 (70%) 和验证 (30%) 集用于模型评估.
主要成果:
- 确定了六个独立的风险因素:单独的脏,膜厚度,手术分期,手术方法,通道大小和估计的膜过率.
- 诺米图表表现出良好的预测性能,AUC为0.81 (训练组) 和0.84 (验证组).
- 决策曲线分析证实了名图在预测出血风险方面的临床实用性.
结论:
- 开发的诺米图谱是估计PCNL后重大出血风险的有效工具.
- 诺莫图帮助外科医生在手术前做出决定,通过识别高风险个体.
- 这种工具可以有助于提高PCNL手术的手术安全性和患者在PCNL手术中的结果.
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