临床外科杂志 ›› 2024, Vol. 32 ›› Issue (9): 970-974.doi: 10.3969/j.issn.1005-6483.2024.09.021

• 论著 • 上一篇    下一篇

预测AngioJet机械血栓抽吸技术的清除效率:新型列线图的构建

何长怀 叶品 张学成 李毅清 蔡传奇   

  1. 430022 武汉,华中科技大学同济医学院附属协和医院血管外科
  • 收稿日期:2023-05-08 出版日期:2024-10-12 发布日期:2024-10-12
  • 通讯作者: 李毅清,Email:qzg599@126.com;蔡传奇,Email:chuanqicai@hust.edu.cn
  • 基金资助:
    国家自然科学基金资助项目(82000729)

Predicting the clearance eficiency of angioJet mechanical thrombus aspiration technique:construction of a novel column line graph

HE Changhuai,YE Pin,ZHANG Xuecheng,LI Yiqing,CAI Chuanqi   

  1. Department of Vascular Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China
  • Received:2023-05-08 Online:2024-09-20 Published:2024-10-12

摘要: 目的 构建急性下肢静脉血栓栓塞症(venous thromboembolism,VTE)病人行AngioJet机械血栓抽吸手术血栓清除率预测模型,指导VTE病人手术治疗方案选择。方法 通过计算行AngioJet机械血栓抽吸手术治疗的83例VTE病人血栓清除率,分析临床数据的相关性,结合LASSO回归模型中的特征性因素,应用多因素Logistic回归分析建立血栓清除率列线图预测模型,使用C指数、校准曲线和决策曲线评估预测模型的准确性。结果 列线图中的预测因素包含年龄、性别、血栓类型、手术史、肿瘤史、吸烟史。该模型显示出较好的预测能力和较高的准确性,C指数为0.795(95%CI 0.6823~0.9057)。决策曲线分析表明,当阈值概率在0.02~0.63时通过列线图预测AngioJet手术的血栓清除率是有效的。结论 VTE类型与血栓清除率具有显著相关性。对于年龄>65岁的男性,有肿瘤史,且血栓类型为中央型血栓,无手术史和无吸烟史的病人,AngioJet血栓抽吸手术能够获得较高的血栓清除率。

关键词: 静脉血栓栓塞症;下肢深静脉血栓形成;Angiojet血栓抽吸;列线图

Abstract: Objective To construct a predictive model of thrombus clearance rate to guide the selection of therapeutic strategies for acute lower extremity venous thromboembolism patients by studying the clinic data of patients who underwent AngioJet mechanical thromboaspiration surgery.Methods By calculating the thrombus clearance rate in 83 VTE patients treated with AngioJet surgery,correlation analysis of clinical data,combined with the characteristic factors in the LASSO regression model,multiple logistic regression analysis was applied to build a prediction model of thrombus clearance rate column line graph,and the accuracy of the prediction model was evaluated using C index,calibration curve and decision curve.Results VTE type was significantly correlated with thrombus clearance rate,and the predictors in the column line plot contained:age,sex,thrombus type,surgical history,tumor history,and smoking history.The model showed great predictive power and high accuracy with a C-index of 0.795 (95%CI:0.682 3-0.905 7).Decision curve analysis showed that prediction of thrombus clearance by column line plot for AngioJet procedure was effective when the threshold probability was in the range of 0.02-0.63.Conclusion In the correlation analysis,VTE type was significantly correlated with thrombus clearance.The results of this study showed that the AngioJet thrombus aspiration procedure was able to achieve a high rate of thrombus clearance in men older than 65 years with a history of tumors,a central thrombus type,no history of surgery,and no history of smoking.

Key words: venous thromboembolism;lower extremity deep vein thrombosis;Angiojet thrombus aspiration;nomogram

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