广西医学2026，Vol.48Issue(3)：376-383,8.DOI:10.11675/j.issn.0253-4304.2026.03.11
胸腔镜肺大疱切除术后患者发生低氧血症的影响因素及列线图预测模型的构建
Influencing factors and construction of nomogram prediction model for the occurrence of hypoxemia in patients after thoracoscopic pulmonary bulla resection
摘要
Abstract
Objective To explore the influencing factors for the occurrence of hypoxemia in patients after video-assisted thoracoscopic surgery(VATS)pulmonary bulla resection(PBR),and to construct a prediction model.Methods Clinical data of 616 patients who underwent VATS PBR were retrospectively analyzed.Patients were divided into model group(n=431)or validation group(n=185)according to the ratio of 7∶3.In the model group,univariate Logistic regression,LASSO regression and multivariate Logistic regression analyses were used to screen the influencing factors for the occurrence of hypoxemia in patients after VATS PBR.A clinical prediction model was constructed based on the influencing factors and clinically recognized variables,and a nomogram was used for visualization.Receiver operating characteristic curve,calibration curve and decision curve were used to evaluate the discrimination,calibration and clinical applicability of the model,and the Bootstrap method was used for internal validation.Results The history of pulmonary infection,preoperative serum albumin level,smoking history,chronic obstructive pulmonary distress(COPD)history,and age were the influencing factors for the occurrence of hypoxemia in patients after VATS PBR(P<0.05).The prediction model based on the above factors and the number of pulmonary bullae had areas under the curve of 0.854 in the model group and 0.845 in the validation group,showing good discrimination ability.The calibration curve revealed that the calibration curve was well fitted to the ideal curve.The results of decision curve analysis indicated that the model provided higher net benefits under different risk thresholds.The risk threshold range of the model group was 2.5%-97.5%,and the risk threshold range of the validation group was 1.5%-98.0%.The results of clinical applicability analysis exhibited that the predictive ability and clinical application value of the model were superior to those of the traditional indicators.Conclusion History of pulmonary infection,preoperative serum albumin level,smoking history,age,and history of COPD are the influence factors for the occurrence of hypoxemia in patients after VATS PBR.The hypoxemia prediction model based on the above factors and the number of pulmonary bullae has a good prediction performance.关键词
胸腔镜下肺大疱切除术/低氧血症/术后/预测模型/影响因素/临床决策Key words
Thoracoscopic pulmonary bulla resection/Hypoxemia/Post operation/Prediction model/Influencing factors/Clinical decision-making分类
医药卫生引用本文复制引用
陈磊,张兵,梅加林,高飞,杨定萍,殷德福,李高峰..胸腔镜肺大疱切除术后患者发生低氧血症的影响因素及列线图预测模型的构建[J].广西医学,2026,48(3):376-383,8.基金项目
保山市人民医院科研计划项目(Bsy2021-ky005) （Bsy2021-ky005）
