摘要：

目的：分析口腔鳞状细胞癌（oral squamous cell carcinoma，OSCC）术后并发肺部感染（pulmonary infection，PI）的危险因素，以建立风险预测模型，并制定针对性护理措施。方法：回顾性分析2018年1月—2020年1月在北京大学深圳医院口腔颌面外科治疗的130例OSCC患者的临床资料，应用单因素分析和logistic多因素回归分析筛选OSCC术后并发PI的危险因素，采用rms程序包和R（R3.5.3）软件包构建风险预测模型，并探讨其护理措施。结果：年龄>60岁（OR=4.918；95%CI：1.969~12.284）、肺部疾病（OR=2.812；95%CI：0.986~8.025）、吸烟（OR=3.241；95%CI：1.191~8.825）、切口感染（OR=2.689；95%CI：1.013~7.135）、营养不良（OR=5.534；95%CI：1.684~18.187）、贫血（OR=3.721；95%CI：1.178~11.758）是OSCC术后并发PI的独立危险因素。基于该6项独立危险因素构建预测术后并发PI的风险列线图模型，并检验模型的预测精准度，实际值几乎等于预测值，受试者操作特征（receiver operating characteristic, ROC）曲线下面积为0.852（95%CI：0.834~0.871），一致性指数C-index为0.863（95%CI：0.829~0.897）。结论：年龄>60岁、肺部疾病、吸烟、切口感染、营养不良、贫血是OSCC术后并发PI的独立危险因素，其构建的风险预测模型具有较高的预测精准度，医务人员可以根据该模型分析术后并发PI风险的可能性，并制定针对性护理措施。

关键词: 口腔鳞状细胞癌, 手术治疗, 肺部感染, 风险模型, 护理措施

Abstract:

Objective: To analyze the risk factors of postoperative pulmonary infection(PI) in oral squamous cell carcinoma (OSCC) so as to establish a risk prediction model and discuss targeted nursing measures. Methods: The clinical data of 130 OSCC patients treated in the Department of Oral and Maxillofacial Surgery of Peking University Shenzhen Hospital from January 2018 to January 2020 were analyzed retrospectively. Univariate analysis and logistic multivariate regression analysis were used to screen the risk factors of postoperative PI in OSCC. The rms package and R(R3.5.3) package were used to build a risk prediction model and targeted nursing measures were discussed. Results: Age>60（OR=4.918; 95%CI: 1.969-12.284）, lung disease（OR=2.812；95%CI：0.986-8.025）, history of smoking（OR=3.241；95%CI: 1.191-8.825）, incision infection（OR=2.689; 95%CI: 1.013-7.135）, malnutrition（OR=5.534; 95%CI: 1.684-18.187）and anemia（OR=3.721; 95%CI: 1.178-11.758） were independent risk factors in postoperative PI. Based on the above 6 independent risk factors, a nomographic model for predicting the risk of postoperative PI in OSCC was constructed. The prediction accuracy of the model was verified. The actual value was almost equal to the predicted value, and the area under the receiver operating characteristic(ROC) curve was 0.852 (95%CI: 0.834-0.871) and the consistency index (C-index) was 0.863 (95%CI: 0.829-0.897). Conclusion: Age>60, lung disease, smoking, incision infection, malnutrition and anemia are independent risk factors for postoperative PI in OSCC. The risk prediction model has high prediction accuracy. Medical staffs can analyze the possibility of the risks of postoperative PI in OSCC and formulate targeted nursing measures according to the model.

Key words: oral squamous cell carcinoma, surgical treatment, pulmonary infection, risk model, nursing measures

中图分类号: 

• R782

• R739.8