广西医学2023，Vol.45Issue(20)：2436-2441,6.DOI:10.11675/j.issn.0253-4304.2023.20.03
经自然腔道内镜手术保胆取石(息肉)术后患者并发症发生风险预测及护理对策
Risk prediction and nursing countermeasure of patients suffering from complications after gallbladder-preserving lithotomy(polyps resection)via natural orifice transluminal endoscopic surgery
摘要
Abstract
Objective To explore the risk and effective nursing countermeasure of patients suffering from complications after gallbladder-preserving lithotomy(polyps resection)via natural orifice transluminal endoscopic surgery(NOTES).Methods The clinical data of 108 patients undergoing NOTES gallbladder-preserving lithotomy(polyps resection)were retrospectively analyzed.Patients were randomly assigned to modeling group(n=88)or verification group(n=20)according to the approximate ratio of 4:1,and patients in the modeling group were further divided into non-postoperative complications group(n=46)or postoperative complications group(n=42)according to the presence of postoperative complications occurred.The clinical data were compared between the non-postoperative complications group and the postoperative complications group.The multivariate Logistic regression model was used to analyze the influencing factors for patients suffering from postoperative complications,and the prediction model was established.The receiver operating characteristic(ROC)curve was used to evaluate the prediction efficiency of the prediction model,and the data from the validation group was employed to performed validation on the prediction model,based on which effective nursing countermeasure was put forward to patients after NOTES gallbladder-preserving lithotomy(polyps resection).Results Among 88 patients in the modeling group,42(47.73％)patients suffered from postoperative complications.There were statistically significant differences in body mass index,preoperative C-reactive protein(CRP)level,preoperative procalcitonin level,and proportion of abnormal coagulation function between the two groups(P＜0.05).The results of multivariate Logistic regression analysis revealed that the elevations of preoperative CRP and procalcitonin levels,as well as abnormal coagulation function were independent risk factors for patients suffering from postoperative complications after NOTES gallbladder-preserving lithotomy(polyps resection)(P＜0.05),and the prediction model established based on the aforementioned risk factors was logit(P)=1.223+0.022 × preoperative CRP+0.159 × preoperative procalcitonin+1.561 × abnormal coagulation function.Areas under the curve of this model for predicting patients suffering from postoperative complications after NOTES gallbladder-preserving lithotomy(polyps resection)was 0.823,accuracy rate was 80.00％,exerting a relatively high predictive value.Patients with calculation of this prediction model larger than 52.189 were the high-risk population for the occurrence of postoperative complications after NOTES gallbladder-preserving lithotomy(polyps resection).Conclusion The elevations of preoperative CRP and procalcitonin levels,and abnormal coagulation function are independent risk factors for patients suffering from postoperative complications after NOTES gallbladder-preserving lithotomy(polyps resection).Patients with calculation of the prediction model established based on the aforementioned factors larger than 52.189 are the high-risk population who suffer from postoperative complications after NOTES gallbladder-preserving lithotomy(polyps resection),for this population,corresponding nursing countermeasures should be taken in time to reduce the occurrence of postoperative complications.关键词
胆囊结石/胆囊息肉/经自然腔道内镜手术/并发症/护理/预测模型Key words
Cholecystolithiasis/Gallbladder polyps/Natural orifice transluminal endoscopic surgery/Complications/Nursing/Prediction model分类
医药卫生引用本文复制引用
温慧萍,马桂芳,潘燕华,温春虹,唐庆林,邓立新,吕新芝,黄雪娟..经自然腔道内镜手术保胆取石(息肉)术后患者并发症发生风险预测及护理对策[J].广西医学,2023,45(20):2436-2441,6.基金项目
漳州市科技计划项目(ZZ2021J25) （ZZ2021J25）
第九○九医院院级科研项目(20YJ002) （20YJ002）
