老年NSCLC患者术后胃肠功能紊乱的危险因素研究

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中图分类号：R734.2 文献标志码：A DOI：10.11958/20252946

Abstract：ObjectiveToinvestigate therisk facrs posperative gastrointestinal dysfunction in elderlypatients with non-smallcell lung cancer （NSCLC），and developandvalidateanindividualizednomogram.MethodsA retrospectivecohort study was conductedand included 309 elderlyNSCLC patients who underwent radicalresection lung cancerinthe singlecenter our hospital.Patients were divided in the disorder group（117cases）andthecontrol group （192 cases）basedon whether gastrointestinal dysfunctionoccurredaftertheoperation.Demographic，clinicalandlaborary indicarswerecolected.TheindependentinfluencingfacrswereanalyzedthroughmultivariateLogisticregression，anda nomogram was constructed based on these results.Internal validation wasconducted using the Bootstrap method （1 000 resamplng），andthediscrimination，calibrationandclinical practicability themodel wereevaluatedthroughareaunder thecuive （AUC），calibration curveanddecisioncurveanalysis （DCA）.ResultsMultivariateLogisticregressionanalysis identified that preoperative malnutrition [OR （95%CI）： 4.276（2.388-7.658）]，preoperative frailty[OR （95%CI）：2.163 （1.211-3.865）]，diabetes[OR （95 %CI ）： 2.366（1.330-4.208）]and preoperative chemotherapy [OR （95%CI）： 2.153（1.214- 3.819）]were independentriskfacrs for posperative gastrointestinal dysfunction inelderlyNSCLCpatientsaftersurgery 0 P<0.05 ）.The higher preoperative maximum voluntary ventilation as a percentage predicted value （MVV%pred）[OR （95%CI）： 0.902（0.874-0.932）] was a protective facr （ P<0.05 ）.A nomogram prediction model integrating these five facrs demonstratedexcellntdiscriminativeability（AUC=0.87，95%CI：0.827-0.919），calibration（meanabsoluteerror0.021） andclinical applicability.ConclusionNomograms constructed basedon facrs such as malnutrition，frailty，diabetes， preoperativechemotherapyand high MVV%can efectively predicttherisk posperative gastrointestinaldysfunction in elderly NSCLC patients.

Key words：carcinoma，non-small-celllung;posperativecomplications;astrointestinal diseases;nomograms;aged; gastrointestinal dysfunction

肺癌是全球发病率和死亡率最高的恶性肿瘤，其中非小细胞肺癌（non-small-cell lung cancer，NSCLC）占 85% ，随着人口老龄化加剧，老年NSCLC患者比例逐年上升[1]。（剩余8952字）