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基于逻辑回归模型分析直肠外科手术后糖尿病患者术后出血的危险因素及干预措施

Analysis of risk factors and intervention measures for postoperative bleeding in patients with diabetes after proctologic surgery based on a logistic regression model.

作者信息

Yu Qiuxiang, Li Peiyao, Li Dan, Wang Lin, Yu Guoshuang, Li Rui

机构信息

Department of Proctology, China-Japan Friendship Hospital, Beijing, China.

Department of International Coloproctology, China-Japan Friendship Hospital, Beijing, China.

出版信息

Front Med (Lausanne). 2025 Jul 22;12:1559707. doi: 10.3389/fmed.2025.1559707. eCollection 2025.

DOI:10.3389/fmed.2025.1559707
PMID:40766074
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12321801/
Abstract

OBJECTIVE

The purpose of this study was to analyse the risk factors for bleeding after proctologic surgery, provide a reference for clinical management and improve postoperative recovery in patients.

METHODS

This study retrospectively analyzed the clinical data of patients undergoing proctologic surgery in our hospital. Patients with postoperative bleeding comprised the study group, whereas those without bleeding formed the control group. A logistic regression model was used to analyse the risk factors for postoperative bleeding in patients undergoing proctologic surgery. A -value < 0.05 was considered statistically significant.

RESULTS

The study found that the risk of postoperative bleeding in men was significantly higher than in women ( < 0.001). Hypertension was identified as an independent risk factor for bleeding ( < 0.001). The incidence of bleeding was significantly higher in patients who received preoperative antibiotics ( = 0.032). The proportion of patients with postoperative dry stool in the bleeding group was significantly higher than in the control group ( < 0.001). The under the curve (AUC) of the prediction model was 0.820, 95%CI: 0.760-0.880, the sensitivity was 72.4%, and the specificity was 82.7%.

CONCLUSION

This study demonstrated that the risk of postoperative bleeding after proctologic surgery was closely associated with several factors, including male sex, hypertension, preoperative antibiotic use and postoperative constipation, all of which significantly increased the risk of bleeding.

摘要

目的

本研究旨在分析直肠外科手术后出血的危险因素,为临床管理提供参考,促进患者术后恢复。

方法

本研究回顾性分析了我院接受直肠外科手术患者的临床资料。术后出血患者组成研究组,未出血患者组成对照组。采用逻辑回归模型分析直肠外科手术患者术后出血的危险因素。P值<0.05被认为具有统计学意义。

结果

研究发现男性术后出血风险显著高于女性(P<0.001)。高血压被确定为出血的独立危险因素(P<0.001)。接受术前抗生素治疗的患者出血发生率显著更高(P = 0.032)。出血组术后大便干结患者比例显著高于对照组(P<0.001)。预测模型的曲线下面积(AUC)为0.820,95%CI:0.760 - 0.880,灵敏度为72.4%,特异度为82.7%。

结论

本研究表明,直肠外科手术后出血风险与多种因素密切相关,包括男性、高血压、术前使用抗生素和术后便秘,所有这些因素均显著增加出血风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0e0/12321801/31eb35a12fd2/fmed-12-1559707-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0e0/12321801/31eb35a12fd2/fmed-12-1559707-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0e0/12321801/31eb35a12fd2/fmed-12-1559707-g001.jpg

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本文引用的文献

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Double diabetes-when type 1 diabetes meets type 2 diabetes: definition, pathogenesis and recognition.双重糖尿病——当 1 型糖尿病遇见 2 型糖尿病:定义、发病机制与识别。
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Anorectal manometry after rectal surgery: a case report with rectal bleeding and perforation.直肠手术后的肛门直肠测压:一例伴有直肠出血和穿孔的病例报告。
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Increased Risk of Bleeding with Topical Metronidazole in a Postoperative Wound after Anal Fistula and Hemorrhoid Surgery: A Propensity Score-Matched Case-Control Study.
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Risk Factors for Recurrence after anal fistula surgery: A meta-analysis.肛瘘手术后复发的危险因素:一项荟萃分析。
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