开发和验证用于预测大腹部手术后患者肠道屏障功能障碍风险的诺米克图:一个前性队列研究
Qinghua Zou1, Ruotian Wang2, Yunfang Dong3
1Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
Frontiers in medicine
|September 8, 2025
概括
一个新的诺米图谱预测了主要腹部手术患者的肠壁功能障碍 (IBDF) 风险. 这种工具有助于早期识别高风险个体,改善临床决策和患者的治疗结果.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 关键护理医学 关键护理医学
背景情况:
- 肠道屏障功能障碍 (IBDF) 可以导致严重的并发症,如全身炎症反应综合征和多器官衰竭.
- 目前用于预测和评估IBDF风险的方法不足,强调需要更好的工具.
- 早期识别患有IBDF风险的患者对于预防不良结果至关重要.
研究的目的:
- 开发和验证用于早期预测患有IBDF风险的大型腹部手术的患者的诺姆图.
- 为识别高风险患者提供一个实用的临床工具.
- 帮助指导及时和适当的临床治疗决策.
主要方法:
- 未来将684名接受重大腹部手术的患者纳入培训和验证队列.
- 单变量和多变量逻辑回归分析以确定IBDF的独立预测因子.
- 使用已识别的预测因子构建名图,并使用AUC,校准图,DCA和CIC评估其性能.
主要成果:
- 确定了八种IBDF的独立预测因素:手术方法,手术时间,血液损失,输液量,白蛋白,白蛋白-6,中性粒细胞与淋巴细胞的比率,以及阿片类药物的使用.
- 开发的名图表显示出高预测准确性,在培训队列中AUC值为0.946,在验证队列中为0.944.
- 校准曲线,DCA和CIC证实了该模型的良好一致性和临床适用性.
结论:
- 成功建立并验证了一种IBDF-nomogram,用于预测主要腹部手术后的IBDF风险.
- 这种名图是用于早期识别高风险患者的新且实用的工具.
- 该模型有可能显著影响IBDF风险患者的临床治疗策略.
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