护理与康复2025，Vol.24Issue(9)：16-21,6.DOI:10.3969/j.issn.1671-9875.2025.09.003
子宫恶性肿瘤术后患者下肢淋巴水肿风险预测模型的构建和验证
Development and validation of a risk prediction model for lower limb lymphedema in patients after sur-gery for uterine malignancies
摘要
Abstract
Objective To analyze the risk factors for lower limb lymphedema in patients after surgery for uterine malig-nancies and to develop a risk prediction model,providing technical support for the clinical identification of high-risk patients.Methods A total of 370 patients who were diagnosed with uterine malignancies and underwent surgical treatment in the Se-cond Affiliated Hospital of Zhejiang University School of Medicine from January 2021 to February 2023 were selected as the modeling group.Based on the occurrence of lower limb lymphedema,they were divided into the lymphedema group(n=76)and the non-lymphedema group(n=294).Univariate analysis and multivariate logistic regression were used to identify inde-pendent risk factors for lower limb lymphedema and to construct the risk prediction model.The predictive performance of the model was evaluated using the receiver operating characteristic(ROC)area under curve(AUC).A total of 159 postop-era-tive patients with uterine malignancies from March to December 2023 were selected as the validation group,and cross-validation was performed to assess the predictive performance of the model.Results The incidence of lower limb lymphed-ema in the modeling group was 20.5％.Postoperative hypoproteinemia(OR=11.920),number of lymph nodes dissected≥20(OR=4.302),postoperative radiotherapy(OR=3.966),and postoperative daily continuous standing time≥ 1 h(OR=10.330)were independent risk factors for the development of lower limb lymphedema,while regular physical exercise was a protective factor(OR=0.041).The AUC of the constructed risk prediction model for lower limb lymphedema in patients after surgery for uterine malignancies was 0.872,with a maximum Youden index of 0.576 and an optimal cut-off value of 0.227.At this cut-off,the sensitivity and specificity of the model were 77.63％and 79.93％.The overall predictive accura-cy of the model in cross-validation with the validation group was 88.05％.Conclusion The prediction model constructed in this study demonstrates good predictive performance,and can effectively predict the risk of lower limb lymphedema in patients after sur-gery for uterine malignancies,providing a reference for healthcare professionals to implement early preventive interventions.关键词
子宫恶性肿瘤/下肢淋巴水肿/危险因素/预测模型Key words
uterine malignancies/lower limb lymphedema/risk factors/prediction model分类
医药卫生引用本文复制引用
杨琳,李峥嵘,徐玉婷,蓝婷..子宫恶性肿瘤术后患者下肢淋巴水肿风险预测模型的构建和验证[J].护理与康复,2025,24(9):16-21,6.基金项目
浙江省医药卫生科技计划项目,编号2024KY1049 （）
