医学信息2024，Vol.37Issue(16)：23-28,6.DOI:10.3969/j.issn.1006-1959.2024.16.005
甲状腺癌患者术后发生喉返神经损伤危险因素分析以及相关预测模型的构建
Analysis of Risk Factors for Postoperative Recurrent Laryngeal Nerve Injury in Patients with Thyroid Cancer and Construction of Related Prediction Models
付蓉 1黄惠桥2
作者信息
- 1. 广西医科大学护理学院,广西 南宁 530000||广西壮族自治区人民医院中心手术室,广西 南宁 530000
- 2. 广西医科大学第二附属医院护理部,广西 南宁 530000
- 折叠
摘要
Abstract
Objective To investigate the risk factors of recurrent laryngeal nerve(RLN)injury in patients with thyroid cancer after surgery,and to construct a relevant prediction model.Methods A total of 380 patients with thyroid cancer who were admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from January 2019 to January 2023 were included in the study.According to whether RLN injury occurred aftersurgery,they were divided into RLN injury group(n=23)and N-RLN injury group(n=357).The general clinical data and operation-related data of the two groups were compared.Multivariate Logistic regression analysis was used to obtain independent predictors of RLN injury in patients with thyroid cancer after operation.Based on independent predictors,a nomogram model for predicting RLN injury in patients with thyroid cancer after operation was established.Bootstrap method and calibration curve were used to verify the nomogram model.The ROC curve for predicting RLN injury in patients with thyroid cancer after operation was drawn,and the predictive efficacy of independent predictors was analyzed.Results Multivariate Logistic regression analysis showed that tumor location,number of operations and intraoperative nerve monitoring were independent predictors of RLN injury in patients with thyroid cancer after surgery(P＜0.05).Based on the results of multivariate analysis,three independent predictors were obtained,namely tumor location,number of operations and intraoperative nerve monitoring,and a nomogram model was constructed to predict RLN injury in patients with thyroid cancer after operation.The discrimination evaluation index C index(C-Index)of the nomogram model was 0.869(95％CI:0.823-0.958).The goodness of fit(H-L)test results showed that the predicted value of RLN injury probability in patients with thyroid cancer after operation was in good agreement with the actual observed value(P＞0.05).The results of ROC analysis showed that the area under the curve(AUC)of tumor location,number of operations and intraoperative nerve monitoring for predicting the probability of RLN injury in patients with thyroid cancer were 0.779(95％CI:0.712-0.834),0.756(95％CI:0.709-0.816)and 0.887(95％CI:0.835-0.935),respectively.The AUC of the combined prediction of the three was 0.937(95％CI:0.887-0.976).Conclusion Tumor location,number of operations and intraoperative nerve monitoring are independent predictors of RLN injury in patients with thyroid cancer after surgery.The nomogram model based on independent predictors has a high predictive value for predicting recurrent laryngeal nerve injury in patients with thyroid cancer after surgery.关键词
甲状腺癌/喉返神经/术中神经监测/预测模型Key words
Thyroidcancer/Recurrent laryngeal nerve/Intraoperative nerve monitoring/Prediction model分类
医药卫生引用本文复制引用
付蓉,黄惠桥..甲状腺癌患者术后发生喉返神经损伤危险因素分析以及相关预测模型的构建[J].医学信息,2024,37(16):23-28,6.
