转化医学杂志2026，Vol.15Issue(1)：6-10,5.DOI:10.3639/j.issn.2095-3097.2026.01.002
肺癌患者胸腔镜下切除术术后气胸的影响因素及列线图预测模型构建
Influencing Factors for Postoperative Pneumothorax After Thoracoscopic Resection in Lung Cancer Patients and Development of A Nomogram Prediction Model
摘要
Abstract
Objective To analyze the influencing factors of pneumothorax after thoracoscopic resection in lung cancer patients and construct a nomogram prediction model.Methods A total of 224 patients with lung cancer admitted to the First Affiliated Hospital of Nanjing Medical University from August 2024 to May 2025 were selected as the study subjects.They were divided into a pneumothorax group(n=20)and a non-pneumothorax group(n=204)based on the occurrence of postoperative pneumothorax.Multivariate logistic stepwise regression analysis was used to identify the influencing factors of postoperative pneumothorax after thoracoscopic resection in lung cancer patients.A nomogram model was constructed and validated.Results The pneumothorax group had a higher proportion of patients aged≥60 years,body mass index≥24 kg/m²,clinical stage Ⅱa-Ⅱb,operation time≥1.5 h,preoperative neoadjuvant therapy,and comorbid emphysema,along with higher white blood cell counts,lower albumin levels,and lower peak expiratory flow compared to the non-pneumothorax group.All differences were statistically significant(P<0.05).Age≥60 years(OR=1.976,95%CI:1.419-2.752),operation time≥1.5 h(OR=2.212,95%CI:1.527-3.204),preoperative neoadjuvant therapy(OR=2.732,95%CI:1.785-4.180),comorbid emphysema(OR=2.330,95%CI:1.587-3.422),and low albumin level(OR=0.393,95%CI:0.259-0.597)were risk factors for postoperative pneumothorax in lung cancer patients(P<0.05).The consistency index of the nomogram model was 0.885(95%CI:0.832-0.938).The calibration curve closely aligned with the ideal curve.The area under the curve(95%CI)of the nomogram for predicting postoperative pneumothorax was 0.904(0.851-0.957),with a specificity of 0.682 and a sensitivity of 0.918.Conclusion The influencing factors of postoperative pneumothorax after thoracoscopic resection in lung cancer patients include age,operation time,preoperative neoadjuvant therapy,comorbid emphysema,and albumin level.The constructed nomogram model has high application value in predicting pneumothorax.关键词
肺肿瘤/手术/气胸/危险因素/列线图Key words
lung cancer/surgery/pneumothorax/risk factors/nomogram引用本文复制引用
高瑄瑄,夏阳,朱媛,储丽娟,张世希,赵慧,胡矜娜..肺癌患者胸腔镜下切除术术后气胸的影响因素及列线图预测模型构建[J].转化医学杂志,2026,15(1):6-10,5.基金项目
国家自然科学基金(82372639) （82372639）
