选择性结直肠手术患者术后早期肠梗阻的危险因素。
Risk factors of early postoperative bowel obstruction for patients undergoing selective colorectal surgeries.
机构信息
Department of Critical Care Medicine, Peking University People's Hospital, 11 Xizhimen South Street, Beijing, 100044, People's Republic of China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, Haidian District, Xue Yuan Road, Beijing, 100191, People's Republic of China.
出版信息
BMC Gastroenterol. 2021 Dec 18;21(1):480. doi: 10.1186/s12876-021-02025-8.
OBJECTIVE
Postoperative bowel obstruction was one of the most severe complications in patients who received colorectal surgeries. This study aimed to explore risk factors of early postoperative obstruction and to construct a nomogram to predict the possibility of occurrence.
METHODS
The records of 1437 patients who underwent elective colorectal surgery in Peking University People's Hospital from 2015 to 2020 were retrospectively collected. Risk factors of early postoperative bowel obstruction were identified by logistic regression analysis and a nomogram was then constructed. Bootstrap was applied to verify the stability of the model.
RESULTS
COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were identified as independent risk factors and were put into a nomogram for predicting early postoperative bowel obstruction. The nomogram showed robust discrimination, with the area under the receiver operating characteristic curve was 0.894 and was well-calibrated.
CONCLUSION
A nomogram including independent risk factors of COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were established to predict the risk of early postoperative bowel obstruction.
目的
术后肠梗阻是接受结直肠手术患者最严重的并发症之一。本研究旨在探讨早期术后梗阻的危险因素，并构建列线图预测发生的可能性。
方法
回顾性收集了 2015 年至 2020 年期间在北京大学人民医院接受择期结直肠手术的 1437 例患者的记录。通过逻辑回归分析确定早期术后肠梗阻的危险因素，并构建列线图。Bootstrap 用于验证模型的稳定性。
结果
COPD、甲状腺功能减退症、益生菌适应证、抗生素使用时间和术后喂养时间被确定为独立危险因素，并纳入预测早期术后肠梗阻的列线图中。该列线图显示出良好的区分度，其受试者工作特征曲线下面积为 0.894，且校准良好。
结论
建立了一个包含 COPD、甲状腺功能减退症、益生菌适应证、抗生素使用时间和术后喂养时间等独立危险因素的列线图，以预测早期术后肠梗阻的风险。
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