1 广东省中医院胃肠外科，广州 510000
目的：了解结肠癌化学药物治疗留置外周静脉置入中心静脉导管(peripherally inserted central catheter，PICC)患者医用黏胶相关性皮肤损伤(medical adhesive-related skin injury，MARSI)的发生情况和风险因素，构建MARSI的风险评分模型，并验证其评估效度。方法：通过便利抽样的方法选择2015年1月至2018年12月在广东省中医院治疗的结肠癌化学药物治疗患者进行资料收集，通过logistic回归分析构建风险评估系统，并采用受试者工作特征曲线(receiver operating characteristic curve，ROC)分析验证评分模型的有效性。结果：共计纳入264例结肠癌化学药物治疗的患者，共有88例患者罹患MARSI (33.3%)，其中建模组49例(31.0%)，验证组39例(36.8%)；女性、年龄>60岁、过敏史、放射治疗史、白蛋白<35 g/L均为MARSI的风险因素(P<0.05)；构建的评分系统得分为0~32分，其中<5分为低危，5~15分为中危，>15分为高危；ROC曲线结果提示：建模组的曲线下面积为0.830，验证组的曲线下面积为0.823，差异均具有统计学意义(P<0.05)；在截断值为6.5分时，两组的约登指数均达到最高。结论：初次构建的风险评分模型具有较好的预测效能，可用于结肠癌化学药物治疗患者PICC后发生MARSI的风险筛查。
Risk of medical adhesive-related skin injury in patients with colon cancer undergoing chemotherapy indwelling peripherally inserted central catheter
This work was supported by the Special Project of TCM Science and Technology Research in Guangdong Hospital of Traditional Chinese Medicine (Key Project), China (YN2016ZD02).
Objective: To investigate the incidence and risk factors of medical adhesive-related skin injury (MARSI) in patients with colon cancer undergoing chemotherapy and indwelling peripherally inserted central catheter (PICC), to construct a risk scoring model of MARSI, and verify its validity. Methods: Data were collected from patients with colon cancer who were treated in Guangdong Hospital of Traditional Chinese Medicine from January 2015 to December 2018 by convenient sampling. Risk assessment system was established by logistic regression analysis, and receiver operating characteristic curve (ROC) analysis was used to verify the validity of the scoring model. Results: A total of 264 patients with colon cancer were enrolled in this study. Among them, 88 patients suffered from MARSI (33.3%), 49 (31.0%) in the model group and 39 (36.8%) in the validation group. Female, age >60 years, allergic history, radiotherapy history and albumin <35 g/L were risk factors of MARSI (P<0.05). Total score of the scoring system was 0–32, of which <5 was low risk, 5–15 was medium risk, and >15 was high risk. ROC results showed that the area under the curve of the modeling group was 0.830, and the area under the curve of the verification group was 0.823, with statistical significance (P<0.05); when the truncation value was 6.5, the Yoden index of the two groups reached the highest. Conclusion: There was a good predictive effect in this risk scoring model constructed at the first time, and can be used for screening the risk of MARSI in patients with colon cancer after PICC catheterization.
colon cancer; peripherally inserted central catheter; skin injury; risk factors; predictive model