日间经尿道输尿管镜激光碎石术围手术期血常规变化及延迟出院风险预测模型的构建

Perioperative changes of blood routine in daytime transurethral ureteroscopic laser lithotripsy and construction of a risk prediction model for delayed discharge.

作者信息

Yuan Huadi, Gao Liyan, Chou Lina, Lin Zhazha, Sun Jiarong, Zhang Hao, Gao Wenjun, Wang Bohan

机构信息

Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88, Jiefang Road, Shangcheng District, Hangzhou, 310000, Zhejiang, China.

Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88, Jiefang Road, Shangcheng District, Hangzhou, 310000, Zhejiang, China.

出版信息

Urolithiasis. 2025 Jun 9;53(1):108. doi: 10.1007/s00240-025-01770-9.

DOI:10.1007/s00240-025-01770-9

PMID:40488787

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12148984/

Abstract

Day surgery is critical for efficient healthcare delivery, but delayed discharge remains a key quality metric. This study investigates perioperative blood index changes during transurethral ureteroscopic laser lithotripsy (TULL) and constructs a risk prediction model for delayed discharge. A retrospective analysis of 526 TULL day surgery patients (2017-2021) compared normal (n = 412) and delayed discharge groups (n = 114). Blood indicators (WBC, Hb, Lymph#, Mono#, Neut#, Eos#) and clinical variables were analyzed. Logistic regression and ROC curves evaluated predictive factors. Delayed discharge was linked to longer operation time (OR = 1.024) and higher urine WBC (OR = 1.001), while Mono# showed protective effects (OR = 0.127). The model achieved an AUC of 0.710 (95% CI: 0.637-0.787), with strong calibration. The model enables early identification of high-risk patients, guiding interventions to reduce delayed discharge and improve day surgery management.

摘要

日间手术对于高效的医疗服务提供至关重要，但延迟出院仍是关键的质量指标。本研究调查经尿道输尿管镜激光碎石术（TULL）围手术期血液指标变化，并构建延迟出院风险预测模型。对526例TULL日间手术患者（2017 - 2021年）进行回顾性分析，比较正常出院组（n = 412）和延迟出院组（n = 114）。分析血液指标（白细胞、血红蛋白、淋巴细胞计数、单核细胞计数、中性粒细胞计数、嗜酸性粒细胞计数）和临床变量。采用逻辑回归和ROC曲线评估预测因素。延迟出院与手术时间延长（OR = 1.024）和尿白细胞升高（OR = 1.001）有关，而单核细胞计数显示出保护作用（OR = 0.127）。该模型的AUC为0.710（95%CI：0.637 - 0.787），具有良好的校准度。该模型能够早期识别高危患者，指导干预措施以减少延迟出院并改善日间手术管理。