中国现代医学杂志2026，Vol.36Issue(8)：110-116,7.DOI:10.3969/j.issn.1005-8982.2026.08.018
非肌层浸润性膀胱癌患者经尿道膀胱肿瘤电切术后发生膀胱灌注并发症的预测模型构建与验证
Construction and validation of a predictive model for bladder perfusion-related complications after transurethral resection of non-muscle-invasive bladder cancer
摘要
Abstract
Objective To construct and validate a predictive model for bladder perfusion-related complications following transurethral resection of bladder tumor(TURBT)in patients with non-muscle-invasive bladder cancer(NMIBC).Methods A retrospective cohort of 106 NMIBC patients undergoing TURBT at our hospital between June 2021 and February 2025 was selected.Patients were divided into a complication group(n=22)and a non-complication group(n=84)based on the occurrence of postoperative bladder perfusion-related complications.Clinical characteristics,surgical parameters,and laboratory indicators were collected.Variables were screened using LASSO regression,and independent risk factors were identified via multivariable logistic regression analysis.A predictive model was constructed with a nomogram.The discriminative power,calibration,and clinical utility of the model were assessed through receiver operating characteristic(ROC)curve analysis,Bootstrap internal validation,and decision curve analysis(DCA).Results The complication group exhibited higher prevalence of diabetes mellitus,longer operative duration,greater intraoperative blood loss,and larger tumor diameter compared to the non-complication group(P＜0.05),while presenting lower albumin levels(P＜0.05).Multivariable logistic regression analysis revealed that concurrent diabetes mellitus[(O^R)=6.923(95％CI:1.110,43.167)],low preoperative albumin levels[(O^R)=0.576(95％CI:0.418,0.794)],prolonged surgery duration[(O^R)=1.063(95％CI:1.003,1.127)],increased intraoperative blood loss[(O^R)=1.152(95％CI:1.041,1.274)],and large tumor diameter[(O^R)=2.857(95％CI:1.076,7.588)]were all risk factors for postoperative bladder perfusion-related complications in NMIBC patients undergoing TURBT(P＜0.05).The ROC curve analysis demonstrated that the AUC of the nomogram for predicting postoperative bladder perfusion-related complications was 0.939(95％CI:0.887,0.991),with a sensitivity of 81.8％(95％CI:0.597,0.948)and a specificity of 90.5％(95％CI:0.821,0.958).The DCA revealed that the model provided significant clinical net benefit across a threshold probability range of 10％to 95％.Clinical impact curve analysis demonstrated that the model had good clinical applicability and risk stratification ability.Conclusion This study established a predictive model based on preoperative and intraoperative indicators,effectively identifying high-risk populations for postoperative bladder perfusion-related complications following TURBT in patients with NMIBC.The model exhibits high predictive accuracy and clinical utility.关键词
非肌层浸润性膀胱癌/经尿道膀胱肿瘤电切术/膀胱灌注/并发症/预测模型/风险评估Key words
non-muscle-invasive bladder cancer/transurethral resection of bladder tumor/bladder perfusion/complication/predictive model/risk assessment分类
医药卫生引用本文复制引用
樊晓昌,宋群,刘雪军,穆家贵..非肌层浸润性膀胱癌患者经尿道膀胱肿瘤电切术后发生膀胱灌注并发症的预测模型构建与验证[J].中国现代医学杂志,2026,36(8):110-116,7.基金项目
江苏省科技计划项目(面上基金项目)(BK20231163) （面上基金项目）
