摘要
目的小儿支气管异物取出术后可伴随喉水肿等严重并发症,构建该类患者术后并发症预测模型,以期为临床防治提供依据。方法选取2000年1月—2022年12月扬州大学附属医院在扬州大学附属医院就诊的107例支气管异物患儿作为研究对象,采用随机数字表法,按照7∶3的比例随机分为建模组(74例)和验证组(33例)。根据患儿术后3个月是否发生并发症将建模组分为并发症组(12例)和无并发症组(62例)。收集患儿资料采用logistic回归分析支气管异物取出术后并发症发生的影响因素,使用R软件构建预测模型,并对模型进行验证。结果年龄较大(P<0.001)、病程较长(P<0.001)、异物长径较长(P<0.001)及诊断至取出时间较长(P<0.029)为小儿支气管异物取出术后并发症发生的独立危险因素(P<0.05);H-L拟合度曲线(有效性)示,建模组χ^(2)=6.856,P=0.427;验证组χ^(2)=6.125,P=0.351。ROC曲线(区分度)示,建模组ROC曲线下面积为0.901(95%CI:0.862~0.933),敏感性为82.61%、特异性为86.22%;验证组ROC曲线下面积为0.852(95%CI:0.806~0.890),敏感性为82.61%、特异性为73.62%。结论年龄较大、病程较长、异物长径较长及诊断至取出时间较长为小儿支气管异物取出术后并发症发生的独立危险因素。
Objective To establish a predictive model for postoperative complications in children with laryngeal edema after removal of bronchial foreign bodies,so as to provide evidence for clinical prevention and treatment.Methods A total of 107 children with bronchial foreign bodies admitted to the Affiliated Hospital of Yangzhou University from January 2000 to December 2022 were selected as the study objects children with bronchial foreign bodies treated in the Affiliated Hospital of Yangzhou University were selected as research subjects,and were randomly divided into modeling group(74 cases)and verification group(33 cases)according to the ratio of 7:3,using the random number table method.The modeling group was divided into complication group(12 cases)and non-complication group(62 cases)according to whether complications occurred 3 months after surgery.Logistic regression was used to analyze the factors influencing complications after removal of bronchial foreign bodies.The R software was used to construct a prediction model and the model was verified.Results Older age(P<0.001),longer disease duration(P<0.001),longer length diameter of the foreign body(P<0.001)and longer time from diagnosis to removal(P<0.029)were independent risk factors for postoperative complications of bronchial foreign body removal in children(P<0.05).H-L fit curve(validity)shows that modeling groupχ^(2)=6.856,P=0.427;verification groupχ^(2)=6.125,P=0.351.The ROC curve(differentiation)showed that the area under ROC curve of the modeling group was 0.901(95%CI:0.862-0.933),the sensitivity was 82.61%and the specificity was 86.22%.In the verification group,the area under the ROC curve was 0.852(95%CI:0.806-0.890),the sensitivity was 82.61%and the specificity was 73.62%.Conclusion Older age,longer disease duration,longer foreign body length and longer time from diagnosis to removal are independent risk factors for postoperative complications of bronchial foreign body removal in children.
作者
王莉
倪春梅
仇丽
徐金梅
王蓓
WANG Li;NI Chunmei;QIU Li;XU Jinmei;WANG Bei(Department of Pediatrics,the Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu 225000,China)
出处
《中华全科医学》
2023年第5期732-735,共4页
Chinese Journal of General Practice
基金
江苏省卫生健康委科研项目(M2021076)。
关键词
支气管异物取出术
并发症
危险因素
儿童
Removal of bronchial foreign body
Complications
Risk factors
Children
