Method for predicting abnormal indexes after thoracic surgery

Abstract

The invention discloses a method for predicting abnormal indexes after thoracic surgery, and relates to the technical field of medical treatment, and the main scheme is as follows: obtaining historical data related to thoracic surgery and preoperative examination, basic information, intraoperative and postoperative recovery data of a patient, and respectively calculating a preoperative comprehensive value, a basic information evaluation value, an intraoperative risk index and a postoperative recovery index; further obtaining a predicted postoperative infection index and a predicted cardiopulmonary function index; calculating a postoperative infection index threshold value and a cardiopulmonary function index threshold value according to the historical data; by comparing a prediction index with a threshold value, triggering corresponding early warning and formulating postoperative management and intervention strategies of different levels, the postoperative rehabilitation quality and safety of a thoracic surgery patient are improved, a comprehensive method is provided for postoperative management of the thoracic surgery patient, risks can be found in time, targeted measures can be taken, and the postoperative rehabilitation safety of the thoracic surgery patient is improved. The operation success rate and the patient life quality are improved.

Description

Technical Field

[0001] The present invention relates to the field of medical technology, and in particular to a method for predicting abnormal postoperative indicators of thoracic surgery. Background Art

[0002] Thoracic surgery is highly complex and risky. Patients face many problems during their postoperative recovery, such as infection and abnormal cardiopulmonary function. Accurately assessing postoperative risks and formulating effective management and intervention strategies are crucial to improving the quality and safety of patients' recovery. However, there is currently a lack of a comprehensive and systematic method to comprehensively consider factors at all stages before, during, and after surgery in order to achieve accurate prediction and management of postoperative risks.

[0003] In existing technologies, some methods use a single factor or a few factors to assess postoperative risk, such as relying solely on the results of a preoperative examination or the duration of the operation. Some systems may combine some preoperative and postoperative data for simple analysis, but lack comprehensive integration and in-depth analysis of data at all stages. Usually, empirical judgment and relatively simple statistical methods are used to assess risk and formulate postoperative management strategies.

[0004] The existing technology is not comprehensive enough in assessing postoperative risks, and fails to fully consider the combined impact of multiple aspects such as preoperative examinations, basic patient information, intraoperative conditions, and postoperative recovery. Secondly, the accuracy and reliability of existing methods are limited, and it is difficult to accurately predict risks such as postoperative infection and abnormal cardiopulmonary function. Furthermore, the existing technology lacks specificity when formulating postoperative management and intervention strategies, and cannot formulate personalized plans based on different risk levels, thus affecting the patient's postoperative rehabilitation effect and safety. Summary of the invention

[0005] 1. Technical issues to be resolved In view of the shortcomings of the existing technology, the present invention provides a method for predicting abnormal postoperative indicators of thoracic surgery. Through calculation formulas and data integration, compared with existing simple statistical methods and empirical judgments, it can more accurately predict the risks of postoperative infection and abnormal cardiopulmonary function. The calculation of the postoperative infection index integrates factors from multiple stages before, during and after the operation, thereby improving the accuracy and reliability of risk prediction. According to the comparison result between the prediction index and the threshold, the corresponding early warning is triggered and different levels of postoperative management and intervention strategies are formulated. It is possible to formulate a personalized plan based on the patient's specific risk level, thereby improving the patient's postoperative rehabilitation effect and safety.

[0006] (II) Technical solution To achieve the above objectives, the present invention is implemented through the following technical solutions: A method for predicting abnormal postoperative indicators of thoracic surgery, comprising: Obtain historical data of thoracic surgery and patients' preoperative examination data, basic information data, intraoperative data, and postoperative recovery data; Calculate the preoperative comprehensive value based on the preoperative examination data ; Calculate the basic information evaluation value based on the patient's basic information data ; Calculate the intraoperative risk index based on intraoperative data ; Calculate the postoperative recovery index based on the postoperative recovery data ; According to the preoperative comprehensive value , basic information evaluation value , intraoperative risk index Postoperative recovery index , calculate and predict postoperative infection index ; According to the postoperative recovery data and postoperative infection index Calculate the predicted cardiopulmonary function index ; Calculate postoperative infection index threshold based on historical data and cardiopulmonary function index threshold ; Postoperative infection index Threshold of postoperative infection index Compare and determine whether to trigger infection warning, formulate corresponding postoperative management and intervention strategies, and predict cardiopulmonary function index Cardiopulmonary function index threshold Make a comparison to determine whether an abnormal cardiopulmonary function warning is triggered and develop appropriate postoperative management and intervention strategies.

[0007] In the preferred embodiment of the above method for predicting abnormal postoperative indexes of thoracic surgery: calculating the preoperative comprehensive value The specific steps are: Preoperative examination data including white blood cell count , Red blood cell measured value , platelet measured value , minimum white blood cell count , maximum white blood cell count , minimum red blood cell value , maximum red blood cell , minimum platelet and platelet maximum ; According to the preoperative examination data, calculate the preoperative comprehensive value , the specific formula is as follows:

[0008] in, Representative white blood cell value The weight coefficient is 0.1< ≤0.3, The measured value of red blood cells The weight coefficient is in the range of 0.3≤ ≤0.6, Platelet count The weight coefficient is 0.2≤ ≤0.5, and + + =1.

[0009] In the preferred embodiment of the above-mentioned method for predicting abnormal postoperative indicators of thoracic surgery: calculating the basic information evaluation value The specific steps are: Basic information data including age , Gender Rating , weight value and past medical history score ; Get the maximum age of patients undergoing thoracic surgery , minimum age , Maximum weight value And the minimum weight value ; According to the patient's basic information data and the maximum age , minimum age , Maximum weight value And the minimum weight value , calculate the basic information evaluation value , the specific formula is as follows:

[0010] in, For age The impact factor is 0.1≤ ≤0.3, Score Gender The impact factor is 0.2≤ ≤0.4, Weight value The impact factor is 0.3≤ ≤0.5, Scoring medical history The impact factor is 0.1< ≤0.3 and ; Representative A past medical history score, The value of is 1, 2, 3, ... , Represents the total number of past medical history scores.

[0011] In the preferred embodiment of the above method for predicting abnormal postoperative indicators of thoracic surgery: calculating the intraoperative risk index The specific steps are: Intraoperative data including surgical time factor value , intraoperative blood loss factor value , Anesthesia method factor value , anesthesia time factor value , Surgery type factor value and surgical instrument factor values ; Calculation of intraoperative risk index based on intraoperative data , the specific formula based on: .

[0012] In the preferred embodiment of the above method for predicting abnormal postoperative indexes of thoracic surgery: calculating the postoperative recovery index The specific steps are: Postoperative recovery data including postoperative patient's vital sign factor values , drainage fluid factor value , Laboratory examination factor score , imaging examination factor values , pain assessment score and recovery status factor values ; Calculate the postoperative recovery index based on the postoperative recovery data , the specific formula is as follows:

[0013] in, is the vital sign factor value The weight coefficient is 0.1≤ ≤0.3, Drainage fluid factor The weight coefficient is 0.2≤ ≤0.4, Scoring laboratory test factors The weight coefficient is 0.3≤ ≤0.4, is the imaging examination factor value The weight coefficient is 0.1< ≤0.3, Score the pain assessment The weight coefficient is 0.01< ≤0.05, Recovery factor value The weight coefficient is 0.01< ≤0.05 and .

[0014] In the preferred embodiment of the above-mentioned method for predicting abnormal postoperative indicators of thoracic surgery: calculating and predicting the postoperative infection index The specific steps are: According to the preoperative comprehensive value , basic information evaluation value , intraoperative risk index Postoperative recovery index , calculate and predict postoperative infection index , the specific formula is as follows:

[0015] in, Preoperative comprehensive value The weight coefficient is 0.1≤ ≤0.3, Basic information evaluation value The weight coefficient is 0.2≤ ≤0.4, Intraoperative risk index The weight coefficient is 0.3≤ ≤0.5, Postoperative recovery index The weight coefficient is 0.1< ≤0.3 and .

[0016] In the preferred embodiment of the above method for predicting abnormal postoperative indexes of thoracic surgery: calculating and predicting the cardiopulmonary function index The specific steps are: Postoperative recovery data also includes cardiac output , heart rate , Actual VO2max , systolic blood pressure , diastolic blood pressure , Systolic blood pressure range and diastolic blood pressure range ; Setting a Systolic Blood Pressure Target , diastolic blood pressure target value and predicted VO2max ; According to the systolic blood pressure target , diastolic blood pressure target value , predicting VO2max , cardiac output , heart rate , Actual VO2max , systolic blood pressure , diastolic blood pressure , Systolic blood pressure range , diastolic blood pressure range Postoperative infection index , calculate and predict cardiopulmonary function index , the specific formula is as follows:

[0017] Among them, heart rate The value of >0; predicted VO2max The value of >0; systolic blood pressure range The value of >0; diastolic blood pressure range The value of >0.

[0018] In the preferred embodiment of the above-mentioned method for predicting abnormal postoperative indicators of thoracic surgery: calculating the postoperative infection index threshold The specific steps are: Historical data including historical postoperative infection index ; According to the historical postoperative infection index Calculation of postoperative infection index threshold , the specific formula is as follows:

[0019] in, Representative The postoperative infection index of each patient was The value of is 1, 2, 3, ... ; represents the total number of historical patient samples, Represents the mean value constant.

[0020] In the preferred embodiment of the above method for predicting abnormal postoperative indexes of thoracic surgery: calculating the threshold value of the cardiopulmonary function index The specific steps are: Historical data also includes historical ECG scores , historical echocardiographic scores and historical lung function scores ; Based on historical ECG scoring , historical echocardiographic scores and historical lung function scores Calculation of cardiopulmonary function index threshold , the specific formula is as follows:

[0021] in, For the ECG score, The value of is 1, 2, 3, ... , Represents the total number of ECG parameter samples; For the Cardiac ultrasound scores, The value of is 1, 2, 3, ... , represents the total number of cardiac ultrasound parameter samples; For the Lung function scores, The value of is 1, 2, 3, ... , represents the total number of samples of lung function parameters; Representative ECG score The weight coefficient is 0.1< ≤0.3, Scoring cardiac ultrasound The weight coefficient is in the range of 0.3≤ ≤0.6, Scoring lung function The weight coefficient is 0.2≤ ≤0.5, and + + =1.

[0022] In the preferred embodiment of the above-mentioned method for predicting abnormal postoperative indicators of thoracic surgery, the specific method for determining whether to trigger an infection warning is: Postoperative infection index threshold set Including the first threshold and secondary threshold ,in, < ; When predicting postoperative infection index ≤ When the infection warning is not triggered, routine postoperative management is formulated; when <Prediction of postoperative infection index ≤ When the infection is detected, a first-level infection warning is triggered and an intermediate postoperative management and intervention strategy is formulated; when <Prediction of postoperative infection index When the infection is detected, a secondary infection warning is triggered and advanced postoperative management and intervention strategies are formulated; The method for determining whether the abnormal cardiopulmonary function warning is triggered is: Cardiopulmonary function index threshold set Including basic threshold and Advanced Threshold ,in, < ; When predicting cardiopulmonary function index ≤ When the patient is in the hospital, the cardiopulmonary function warning is not triggered and routine postoperative management is formulated; when <Predicted cardiopulmonary function index ≤ When the patient is in the hospital, it will trigger an early warning of mild abnormal cardiopulmonary function and formulate enhanced postoperative management and intervention strategies; when <Predicted cardiopulmonary function index When severe cardiopulmonary dysfunction occurs, an early warning is triggered and a special postoperative management and intervention strategy is formulated.

[0023] (III) Beneficial effects The present invention provides a method for predicting abnormal postoperative indicators of thoracic surgery, which has the following beneficial effects: (1) Comprehensively collect historical data related to thoracic surgery and the patient's preoperative, intraoperative and postoperative data, providing a rich information basis for subsequent accurate evaluation and management. It can cover the entire surgical process and various aspects of the patient's condition, avoiding inaccurate evaluation due to missing data.

[0024] (2) Comprehensive preoperative examination data can be used to comprehensively evaluate the impact of the patient's preoperative physical condition on the surgery, which helps doctors understand the patient's basic condition in advance and provides an important basis for formulating surgical plans and evaluating postoperative risks. Calculating the basic information evaluation value can provide a more comprehensive understanding of the potential impact of individual differences in patients on surgery and postoperative recovery, and can formulate more targeted management strategies for patients with different basic conditions. By evaluating intraoperative factors such as operation time, blood loss, and anesthesia method, the intraoperative risk index is calculated to quantify the risk level during the operation, which helps doctors adjust strategies in a timely manner during the operation, reduce intraoperative risks, and improve the safety of the operation. Comprehensive consideration of postoperative vital signs, drainage fluid status and other factors can be used to calculate the postoperative recovery index, which objectively reflects the patient's postoperative recovery status, provides a basis for timely adjustment of postoperative management strategies, and promotes better recovery of patients.

[0025] (3) Combining preoperative, intraoperative, and postoperative data to calculate the predicted postoperative infection index and predicted cardiopulmonary function index can more accurately predict the patient's risk of postoperative infection and cardiopulmonary function abnormalities, detect potential problems in advance, and take timely and effective prevention and intervention measures.

[0026] (4) Thresholds are calculated based on historical data to make the assessment more scientific and objective. By comparing with the threshold to determine whether an early warning is triggered, appropriate postoperative management and intervention strategies can be formulated in a timely manner, thereby improving the pertinence and effectiveness of postoperative management, reducing the incidence of postoperative complications, and improving the quality and safety of patient rehabilitation. BRIEF DESCRIPTION OF THE DRAWINGS

[0027] Figure 1 The figure is a flow chart of the method for predicting abnormal postoperative indicators of thoracic surgery according to the present invention. DETAILED DESCRIPTION

[0028] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0029] See also Figure 1 The present invention provides a method for predicting abnormal postoperative indicators of thoracic surgery, including: obtaining historical data of thoracic surgery and patients' preoperative examination data, basic information data, intraoperative data and postoperative recovery data.

[0030] Specifically, historical data is used to calculate whether the threshold evaluation indicators are abnormal, preoperative examination data is used to evaluate the patient's preoperative physical condition, basic information data provides a basis for evaluating the patient's basic health status, intraoperative data reflects the risks during the operation, and postoperative recovery data is used to evaluate the patient's postoperative recovery.

[0031] Calculate the preoperative comprehensive value based on the preoperative examination data ; Calculate the basic information evaluation value based on the patient's basic information data ; Calculate the intraoperative risk index based on intraoperative data ; Calculate the postoperative recovery index based on the postoperative recovery data .

[0032] Specifically, the preoperative comprehensive value is calculated by comprehensively considering the patient's various preoperative examination indicators to obtain a comprehensive score reflecting the patient's preoperative physical condition; the basic information evaluation value is based on the patient's basic information and is calculated to assess the patient's basic health level.

[0033] Furthermore, an intraoperative risk index is calculated based on intraoperative data to evaluate the risk status during the operation in real time and provide doctors with immediate surgical risk assessment.

[0034] Furthermore, a postoperative recovery index is calculated based on the postoperative recovery data to evaluate the patient's postoperative recovery status. The calculation of the postoperative recovery index provides doctors with a quantitative assessment of the patient's recovery status, which helps to formulate a personalized postoperative rehabilitation plan.

[0035] According to the preoperative comprehensive value , basic information evaluation value , intraoperative risk index Postoperative recovery index , calculate and predict postoperative infection index ; According to the postoperative recovery data and postoperative infection index Calculate the predicted cardiopulmonary function index .

[0036] Specifically, the predicted postoperative infection index and predicted cardiopulmonary function index are calculated based on the preoperative comprehensive value, basic information assessment value, intraoperative risk index and postoperative recovery index. The predicted postoperative infection index and predicted cardiopulmonary function index are calculated by comprehensively considering the patient's preoperative, intraoperative and postoperative data to provide doctors with a prediction of the patient's future possible complication risks.

[0037] Calculate postoperative infection index threshold based on historical data and cardiopulmonary function index threshold .

[0038] Specifically, the module calculates the postoperative infection index threshold and the cardiopulmonary function index threshold based on historical data to determine whether the patient is in a dangerous state. The calculation of the threshold provides doctors with a reference standard for determining whether the patient is in a dangerous state.

[0039] Postoperative infection index Threshold of postoperative infection index Compare and determine whether to trigger infection warning, formulate corresponding postoperative management and intervention strategies, and predict cardiopulmonary function index Cardiopulmonary function index threshold Make a comparison to determine whether an abnormal cardiopulmonary function warning is triggered and develop appropriate postoperative management and intervention strategies.

[0040] Specifically, the early warning and strategy formulation module will compare the predicted postoperative infection index with the postoperative infection index threshold to determine whether an infection warning is triggered and formulate corresponding postoperative management and intervention strategies; at the same time, the predicted cardiopulmonary function index will be compared with the cardiopulmonary function index threshold to determine whether an abnormal cardiopulmonary function warning is triggered and formulate corresponding postoperative management and intervention strategies. The early warning and strategy formulation module will promptly issue early warning signals and generate personalized postoperative management and intervention strategies by real-time monitoring of the comparison results of the patient's predicted index and the threshold, providing doctors with scientific decision-making support.

[0041] In the preferred embodiment of the above method for predicting abnormal postoperative indexes of thoracic surgery: calculating the preoperative comprehensive value The specific steps are: Preoperative examination data including white blood cell count , Red blood cell measured value , platelet measured value , minimum white blood cell count , maximum white blood cell count , minimum red blood cell value , maximum red blood cell , minimum platelet and platelet maximum .

[0042] According to the preoperative examination data, calculate the preoperative comprehensive value , the specific formula is as follows:

[0043] in, Representative white blood cell value The weight coefficient is 0.1< ≤0.3, The measured value of red blood cells The weight coefficient is in the range of 0.3≤ ≤0.6, Platelet count The weight coefficient is 0.2≤ ≤0.5, and + + =1.

[0044] It should be noted that for white blood cells, red blood cells and platelets, the difference between the measured value and the minimum value of their concentration is calculated respectively; these differences are divided by the difference between their respective maximum and minimum values. The purpose of this step is to normalize the index values ​​of different dimensions and ranges to between 0 and 1, which is convenient for subsequent weighted summation; according to the given weight coefficient , , , perform weighted summation on the normalized differences above, and the range of weight coefficients is v1 between 0.1 and 0.3, Between 0.3 and 0.6, Between 0.2 and 0.5, and the sum of the three must be equal to 1; the result of the weighted summation is taken as the preoperative comprehensive value Pr; the formula comprehensively considers the relationship between the preoperative measured values ​​of the three indicators of white blood cells, red blood cells, and platelets and the normal range, as well as their importance in assessing the preoperative comprehensive health status through the steps of difference calculation, normalization processing, weighted summation, etc., to obtain a quantitative indicator preoperative comprehensive value Pr that can reflect the patient's preoperative comprehensive health status.

[0045] This formula can comprehensively and objectively evaluate the patient's comprehensive preoperative health status by taking into account key preoperative examination indicators such as white blood cells, red blood cells, and platelets, providing doctors with more accurate decision-making basis.

[0046] Secondly, the normalization step in the formula effectively eliminates the influence of the dimension and range differences between different indicators, making each indicator comparable in the evaluation and improving the accuracy and reliability of the evaluation results; by introducing the weight coefficient, the formula can be flexibly adjusted according to the importance of different indicators in the evaluation, so that the evaluation results are more in line with the actual clinical needs; the calculation process of the formula is relatively simple and clear, easy to understand and operate, which is conducive to its wide application and promotion in clinical practice, and provides a scientific and effective method for the preoperative evaluation of patients undergoing thoracic surgery.

[0047] In the preferred embodiment of the above-mentioned method for predicting abnormal postoperative indicators of thoracic surgery: calculating the basic information evaluation value The specific steps are: Basic information data including age , Gender Rating , weight value and past medical history score .

[0048] Obtain the maximum age of patients undergoing thoracic surgery based on historical thoracic surgery data , minimum age , Maximum weight value And the minimum weight value .

[0049] According to the patient's basic information data and the maximum age , minimum age , Maximum weight value And the minimum weight value , calculate the basic information evaluation value , the specific formula is as follows:

[0050] in, For age The impact factor is 0.1≤ ≤0.3, Score Gender The impact factor is 0.2≤ ≤0.4, Weight value The impact factor is 0.3≤ ≤0.5, Scoring medical history The impact factor is 0.1< ≤0.3 and ; Representative A past medical history score, The value of is 1, 2, 3, ... , Represents the total number of past medical history scores.

[0051] It should be noted that by comparing the patient's actual age with the maximum and minimum age values, a relative value is obtained. This relative value reflects the position of the patient's age in the entire possible age range, multiplied by the influencing factor , The value range is 0.1⩽ ⩽0.3, indicating that age is relatively less important in basic information assessment but cannot be ignored. Older or younger patients may have differences in surgical risks and recovery capabilities. This part of the calculation aims to quantify this difference. Gender scores are usually divided into male and female cases, with males being 1 and females being 0.5, multiplied by the impact factor , The value range is 0.2⩽ ⩽0.4, indicating that the gender score is important in the basic information assessment. Patients with different gender scores may have differences in physiological characteristics, disease susceptibility, etc. This part of the calculation takes into account the potential impact of the gender score on surgery and postoperative recovery.

[0052] Age factor, compare the patient's actual weight with the maximum and minimum weight values ​​to get the relative value of the weight value. The weight value is in kilograms. This relative value reflects the position of the patient's weight value within the range of all patients' weight values. Square it and multiply it by the influencing factor , The value range is 0.3⩽ ⩽0.5, indicating that weight is important in basic information assessment and may be more important than age. Too high or too low weight may affect the difficulty of surgery and the patient's recovery. The square operation may be to emphasize the impact of weight values ​​deviating from the normal range. Obtain medical records through the hospital diagnosis and treatment system or medical history query. If the normal blood pressure in the past medical history is 90-119mmHg systolic and 60-79mmHg diastolic, such patients are scored as 0 points. If the systolic blood pressure is 120-139mmHg or the diastolic blood pressure is 80-89mmHg in the pre-hypertension period, such patients are scored as 1 point, which means that the blood pressure has a certain tendency to rise. Grade 1 hypertension has a systolic blood pressure of 140-159mmHg or a diastolic blood pressure of 90-99mmHg, and a score of 2 points, indicating that the blood pressure is significantly increased. Grade 2 hypertension has a systolic blood pressure of 160-179 mmHg or a diastolic blood pressure of 100-109 mmHg, with a score of 3 points, indicating that the blood pressure is high. Grade 3 hypertension has a systolic blood pressure of ≥180 mmHg or a diastolic blood pressure of ≥110 mmHg, with a score of 4 points, indicating that the blood pressure is at a very high level. If the patient has no relevant medical history, the score is 0 points. Each medical history is accumulated and multiplied by the influencing factor. , The value range is 0.1< ≤0.3, indicating that the past medical history score also has a certain influence on the basic information assessment. The past medical history score may increase the risk of surgery and affect postoperative recovery. By assigning corresponding weights to different past medical history scores and accumulating them, the impact of the patient's overall health history on the surgery can be comprehensively considered; the formula requires , ensuring that the sum of the influencing factors of each factor is 1, so that the basic information evaluation value is a relative value that comprehensively considers all factors, which can more comprehensively reflect the potential impact of the patient's basic information status on thoracic surgery.

[0053] This formula comprehensively considers multiple factors such as age, gender score, weight value and medical history score, comprehensively evaluates the impact of patients' basic information on thoracic surgery, and avoids the one-sidedness of single-factor evaluation. For the age factor, it can accurately reflect the differences in surgical risks and recovery abilities of patients of different age groups, and provide a basis for doctors to formulate personalized treatment plans. The consideration of gender score factors helps to make more accurate risk assessments based on the physiological characteristics of different gender scores. The weight value factor emphasizes the impact of weight values ​​deviating from the normal range on surgery, prompting doctors to pay more attention to surgical preparation and postoperative care for patients with abnormal weight values. The inclusion of past medical history scores can provide early warning of potential risks, enabling doctors to take targeted preventive measures and reduce the incidence of surgical complications. Overall, this formula helps to improve the safety and postoperative recovery of thoracic surgery and provide patients with better medical services.

[0054] In the preferred embodiment of the above method for predicting abnormal postoperative indicators of thoracic surgery: calculating the intraoperative risk index The specific steps are: Intraoperative data including surgical time factor value , intraoperative blood loss factor value , Anesthesia method factor value , anesthesia time factor value , Surgery type factor value and surgical instrument factor values ; Calculation of intraoperative risk index based on intraoperative data , the specific formula based on: .

[0055] It should be noted that the surgical time factor value Before the operation begins, the surgeon or operating room nurse records the specific time when the operation begins, accurate to the minute. After the operation ends, the end time is also recorded. When calculating the operation time, the end time is subtracted from the start time to get the number of minutes the operation lasts, which is the operation time factor value. For example, if the operation starts at 9:30 am and ends at 11:45 am, then the operation time is 135 minutes, OT=135.

[0056] Intraoperative blood loss factor value During the operation, a suction device is used to collect bleeding. The suction device usually has a metering device that can directly read the amount of bleeding and record it as the suction device bleeding amount. The gauze and other blood-absorbing materials used during the operation can be estimated by weighing after the operation. First weigh the dry gauze, then weigh the gauze with blood after use. The difference between the two is divided by the blood specific gravity to get the gauze blood absorption amount. Add the suction device bleeding amount and the gauze blood absorption amount to get the total intraoperative bleeding amount, accurate to milliliters, which is the intraoperative bleeding amount factor value. .

[0057] Anesthesia method factor value The anesthesia method information is obtained from the anesthesia record. If it is general anesthesia, Assign a specific value, set =8; if spinal anesthesia is used, =5; if it is local anesthesia, set =3.

[0058] Anesthesia time factor value When anesthesia starts, the anesthesiologist records the start time, accurate to the minute. When anesthesia ends, the end time is also recorded. When calculating the anesthesia time, the end time is subtracted from the start time to get the number of minutes the anesthesia lasts, which is the anesthesia time factor value. For example, if the anesthesia starts at 9:15 am and ends at 12:00 pm, then the anesthesia time is 165 minutes. =165.

[0059] Surgery type factor value The type of surgery is determined based on the surgical record. For example, a complex pneumonectomy is difficult and risky. =10; lobectomy, the difficulty and risk are relatively lower, =7; simpler surgeries such as lung wedge resection, =4.

[0060] Surgical instrument factor value The surgical record will record the surgical instruments used in detail. If special, advanced instruments that may increase surgical risks are used, such as robot-assisted surgical instruments, =6; if conventional surgical instruments are used, =3.

[0061] This formula adds the values ​​of factors such as operation time, intraoperative bleeding volume, anesthesia method, anesthesia time, operation type and surgical instruments, and comprehensively considers the impact of these factors on intraoperative risk to derive an intraoperative risk index. This index can help doctors assess the risk level of the operation and formulate corresponding surgical plans and risk management measures.

[0062] This formula comprehensively considers multiple key factors in surgery and avoids the one-sidedness of single-factor evaluation. Factors such as operation time, blood loss, anesthesia method, anesthesia time, operation type and surgical instruments jointly determine the intraoperative risk. Comprehensive consideration can more accurately reflect the actual situation. For doctors, they can formulate targeted surgical plans and emergency measures in advance based on the calculated intraoperative risk index to improve the safety of surgery. For example, when facing a higher risk index, they can choose anesthesia methods more carefully, optimize surgical steps, and prepare sufficient blood supply. At the same time, this formula helps to quantify surgical risks, provide a clear basis for communication and decision-making between medical teams, and promote collaboration in all links. In addition, by clarifying the contribution of each factor, it can also provide direction for subsequent surgical improvements and quality control, continuously improve the overall level of thoracic surgery, and better protect the life and health of patients and the effectiveness of surgery.

[0063] In the preferred embodiment of the above method for predicting abnormal postoperative indexes of thoracic surgery: calculating the postoperative recovery index The specific steps are: Postoperative recovery data including postoperative patient's vital sign factor values , drainage fluid factor value , Laboratory examination factor score , imaging examination factor values , pain assessment score and recovery status factor values .

[0064] Calculate the postoperative recovery index based on the postoperative recovery data , the specific formula is as follows:

[0065] in, is the vital sign factor value The weight coefficient is 0.1≤ ≤0.3, Drainage fluid factor The weight coefficient is 0.2≤ ≤0.4, Scoring laboratory test factors The weight coefficient is 0.3≤ ≤0.4, is the imaging examination factor value The weight coefficient is 0.1< ≤0.3, Score the pain assessment The weight coefficient is 0.01< ≤0.05, Recovery factor value The weight coefficient is 0.01< ≤0.05 and .

[0066] It should be noted that the patient's postoperative body temperature is measured by a thermometer. The normal body temperature range is around 36℃-37℃. If the body temperature is within the normal range, a specific basic value of 50 is assigned. Assuming the full score is 100, if the body temperature exceeds the normal range, points will be deducted accordingly according to the degree of excess. For every 1℃ increase in temperature, 5 points will be deducted; for every 1℃ decrease in temperature, 3 points will be deducted. The patient's heart rate is monitored using equipment such as an ECG monitor. The normal heart rate range is generally 60-100 beats / minute. If the heart rate is within the normal range, another basic value of 40 is set. If the heart rate exceeds the normal range, points will be added or subtracted according to the degree of excess. For every 10 beats / minute that the heart rate exceeds the upper or lower limit of the normal range, 5 points will be deducted. The patient's blood pressure, including systolic and diastolic pressure, is measured by a sphygmomanometer. The normal blood pressure range varies depending on factors such as age, but generally the systolic pressure is between 90-140 mmHg, and the diastolic pressure is between 60-90 mmHg. If the blood pressure is within the normal range, it is set to a certain base value of 40. If it exceeds the normal range, points will be deducted according to the specific situation. For every 10 mmHg that the systolic or diastolic pressure exceeds the upper or lower limit of the normal range, 5 points will be deducted. Observe the patient's breathing and use an instrument to measure the respiratory rate. The normal respiratory rate is generally 12-20 times / minute. Within the normal range, a certain base value of 30 is set. If it exceeds the range, points will be deducted according to the degree of excess. For every 2 times / minute that exceeds the upper or lower limit of the normal range, 3 points will be deducted. Finally, the scores of body temperature, heart rate, blood pressure and respiratory rate are added together to get the vital sign factor value. .

[0067] Record the drainage volume in the patient's postoperative drainage device. Set the normal drainage volume range according to different surgical types and patient conditions. For thoracic surgery, the normal drainage volume range may be 100-500 ml per day. If the drainage volume is within the normal range, set the base value to 50. If it exceeds the normal range, subtract points according to the degree of excess. For every 50 ml exceeding the upper or lower limit of the normal range, subtract 5 points. Observe the color of the drainage fluid. Under normal circumstances, it may be light red or light yellow. If the color is abnormal, such as bright red, dark red, purulent, etc., subtract points according to the severity of the color. Bright red drainage fluid will be subtracted by 10 points, and purulent drainage fluid will be subtracted by 20 points. Check the properties of the drainage fluid, such as whether it is turbid or has a peculiar smell. If it is turbid or has a peculiar smell, subtract points according to the severity. For turbid drainage fluid, subtract 5 points, and for drainage fluid with a peculiar smell, subtract 10 points. Finally, add the scores of drainage volume, color, and properties to get the drainage fluid factor value. .

[0068] Laboratory test factor score The method for obtaining the factor score can be: checking the patient's blood routine test results, biochemical test results, renal function test results, electrolyte test results, etc., and scoring each one separately; for example, each test result is scored 25 points, and each test result is compared with the normal result. If it meets the normal standard, the item is scored 25 points. If some of the indicators have a small abnormality, such as a deviation of 1% to 10%, the item is deducted by 5 points, if there is a deviation of 10% to 20%, it is deducted by 10 points, and if there is a deviation of 30% to 50%, it is deducted by 15 points. The scores of each item are added together to obtain the laboratory examination factor score. .

[0069] Perform chest X-rays on patients to observe lung conditions and surgical site healing. If the X-ray shows clear lungs and no obvious abnormalities in the surgical site, the baseline value is set at 40. If abnormalities such as lung shadows, effusion, and pneumothorax occur, points are deducted based on severity. A small amount of lung shadows is deducted by 5 points, and a moderate amount of effusion is deducted by 10 points. Perform chest CT scans to provide more detailed image information. The lung and surgical site conditions are evaluated based on the CT results. If the CT scans are good, the baseline value is set at 40. If abnormalities such as masses, inflammation, and tissue necrosis occur, points are deducted based on severity. A small mass is deducted by 10 points, and a widespread inflammation is deducted by 20 points. Finally, add the scores of the chest X-ray and CT scans to get the imaging examination factor value. .

[0070] The pain assessment scale is used to observe the patient's pain manifestations, facial expressions, body movements, etc., and ask the patient to rate the patient's pain level. If the patient scores no pain, the score is 0; mild pain range is 1 to 3 points, moderate pain range is 4 to 6 points, and severe pain range is 7 to 10 points. The final score is the pain assessment score. .

[0071] Observe the patient's mobility, whether he can turn over, sit up, stand, walk, etc. independently. If the patient can perform these activities completely independently, the basic value is set to 40. If the mobility is limited, deduct points according to the degree of limitation, 10 points if he can only turn over, and 15 points if he can only sit up; assess the patient's compliance with respiratory function exercises, whether he performs deep breathing, coughing, blowing balloons and other exercises on time. If the patient complies completely, it is set to a certain basic value of 30. If the compliance is poor, deduct points according to the specific situation, 5 points if he occasionally does not exercise, and 10 points if he often does not exercise; observe the patient's diet and assess whether the nutritional intake is sufficient. If the patient has a normal diet and good nutritional intake, it is set to a certain basic value of 30. If the nutritional intake is insufficient, deduct points according to the degree, 10 points if the food intake is reduced by half, and 20 points if he can hardly eat. Finally, add the scores of mobility, respiratory function exercise compliance and nutritional intake to obtain the rehabilitation factor value. .

[0072] The formula takes into account multiple aspects of postoperative recovery by multiplying each factor value with the corresponding weight coefficient and then adding them together. Each factor value reflects the patient's specific situation in this aspect, while the weight coefficient reflects the relative importance of the factor in the overall postoperative recovery assessment. In this way, a comprehensive postoperative recovery index can be obtained. This index can help doctors fully understand the patient's postoperative recovery, identify problems in a timely manner and take appropriate intervention measures. If the PRI is low, doctors can adjust the treatment plan and nursing measures in a targeted manner according to the specific circumstances of each factor value to promote the patient's recovery. At the same time, the sum of the weight coefficients in the formula is 1, which ensures that the relative proportion of each factor in the comprehensive evaluation is reasonable and avoids a certain factor from excessively affecting the evaluation results.

[0073] This formula comprehensively considers multiple key aspects of postoperative recovery. Vital signs reflect the patient's basic physiological state, drainage fluid reflects the condition of the surgical site, laboratory tests evaluate physical condition from a microscopic level, imaging examinations intuitively show the recovery effect, pain assessment focuses on patient comfort, and rehabilitation status covers comprehensive factors such as mobility. By integrating these factors, the one-sidedness of single indicator evaluation is avoided, and the overall situation of the patient's postoperative recovery can be more accurately reflected. Different factors are assigned different weight coefficients to make the evaluation more targeted. Doctors can adjust treatment and care plans in a timely manner based on the calculated postoperative recovery index, and intervene in possible problems at an early stage. This formula provides the medical team with a quantitative evaluation tool, which helps team members communicate and collaborate better, work together for the patient's rehabilitation, and improve the overall treatment effect of thoracic surgery and the patient's quality of life.

[0074] In the preferred embodiment of the above-mentioned method for predicting abnormal postoperative indicators of thoracic surgery: calculating and predicting the postoperative infection index The specific steps are: According to the preoperative comprehensive value , basic information evaluation value , intraoperative risk index Postoperative recovery index , calculate and predict postoperative infection index , the specific formula is as follows:

[0075] in, Preoperative comprehensive value The weight coefficient is 0.1≤ ≤0.3, Basic information evaluation value The weight coefficient is 0.2≤ ≤0.4, Intraoperative risk index The weight coefficient is 0.3≤ ≤0.5, Postoperative recovery index The weight coefficient is 0.1< ≤0.3 and .

[0076] It should be noted that the formula multiplies the preoperative comprehensive value, basic information assessment value, and intraoperative risk index by the corresponding weight coefficients, then adds them up, and then subtracts the result of multiplying the postoperative recovery index by the weight coefficient. It comprehensively considers the impact of multiple factors before, during, and after surgery on the risk of postoperative infection. The sum of the weight coefficients of each factor is 1, which ensures that the relative proportion of each factor in the comprehensive evaluation is reasonable. In this way, a predicted postoperative infection index can be obtained, which can help doctors assess the risk of postoperative infection in patients, take corresponding prevention and treatment measures in advance, reduce the incidence of postoperative infection, and improve the quality of patient recovery.

[0077] This formula takes into account multiple key factors before, during and after surgery, comprehensively evaluates the risk of postoperative infection, and avoids the limitations of single-factor evaluation. The preoperative comprehensive value reflects the patient's physical foundation before surgery, providing a reference for doctors to understand the patient's tolerance to surgery in advance. The basic information evaluation value takes into account individual differences in patients, which helps to develop personalized prevention strategies for different patients. The intraoperative risk index reminds doctors to pay attention to risk factors during surgery so that they can adjust the surgical plan in time and reduce the risk of infection. The introduction of the postoperative recovery index emphasizes the importance of good postoperative recovery in reducing the risk of infection. By reasonably setting the weight coefficient, this formula can accurately quantify the risk of postoperative infection and provide doctors with a scientific basis to take preventive measures in advance, such as strengthening anti-infection treatment, optimizing nursing plans, etc., thereby reducing the incidence of postoperative infection and improving the success rate of thoracic surgery and the quality of patient recovery.

[0078] In the preferred embodiment of the above method for predicting abnormal postoperative indexes of thoracic surgery: calculating and predicting the cardiopulmonary function index The specific steps are: Postoperative recovery data also includes cardiac output , heart rate , Actual VO2max , systolic blood pressure , diastolic blood pressure , Systolic blood pressure range and diastolic blood pressure range .

[0079] Setting a Systolic Blood Pressure Target , diastolic blood pressure target value and predicted VO2max ; According to the systolic blood pressure target , diastolic blood pressure target value , predicting VO2max , cardiac output , heart rate , Actual VO2max , systolic blood pressure , diastolic blood pressure , Systolic blood pressure range , diastolic blood pressure range Postoperative infection index , calculate and predict cardiopulmonary function index , the specific formula is as follows:

[0080] Among them, heart rate The value of >0; predicted VO2max The value of >0; systolic blood pressure range The value of >0; diastolic blood pressure range The value of >0.

[0081] It should be noted that for young patients aged 18-40, with reference to the blood pressure range of the normal population and taking into account their good physical tolerance, if the preoperative examination shows that the cardiovascular system functions normally, the systolic blood pressure target value is set at 120 mmHg and the diastolic blood pressure target value is set at 75 mmHg. This is because young people have better vascular elasticity and relatively stronger heart function, and this blood pressure value can ensure the normal perfusion of various organs in the body; for middle-aged patients aged 41-60, with age, the blood vessels may have a certain degree of hardening, and the heart burden will also increase. If there is no obvious cardiovascular disease in the preoperative examination, the systolic blood pressure target value is set at 125-130 mmHg and the diastolic blood pressure target value is set at 75-80 mmHg. This range can not only meet the body's blood supply needs, but also avoid excessive blood pressure causing excessive pressure on blood vessels; for elderly patients over 60 years old, due to the decline of physical function, the elasticity of blood vessels is further reduced, and it can be It may be accompanied by other chronic diseases. If the preoperative evaluation shows that the patient's overall physical condition is good, the systolic blood pressure target value is set at 130-140 mmHg, and the diastolic blood pressure target value is set at 80-85 mmHg. This can ensure blood supply to important organs while reducing the risk of insufficient organ perfusion due to low blood pressure. Different thoracic surgeries have different effects on the patient's cardiopulmonary function. Lobectomy may have a certain impact on the patient's respiratory function, but the impact on cardiac function is relatively small. In this case, the predicted decrease in maximum oxygen uptake is relatively small. If the patient's preoperative maximum oxygen uptake is X ml / kg / min, the postoperative predicted maximum oxygen uptake can be set to X-10% ml / kg / min. For complex surgeries such as pneumonectomy or heart surgery, the impact on cardiopulmonary function is greater, and the predicted decrease in maximum oxygen uptake may be greater. The postoperative predicted maximum oxygen uptake is set to 50%-70% of the preoperative measured value.

[0082] The ratio of cardiac output to heart rate reflects the amount of blood pumped out by the heart with each beat. Under normal circumstances, cardiac output is relatively stable, while heart rate fluctuates within a certain range. If the ratio is high, it means that the heart pumps out more blood per unit time, which may mean better heart function; otherwise, it may indicate weaker heart function. The ratio of actual maximum oxygen uptake to predicted maximum oxygen uptake reflects the comparison between the patient's actual cardiopulmonary function and the expected cardiopulmonary function. If the ratio is close to 1, it means that the patient's cardiopulmonary function is close to the expected level; if the ratio is less than 1, it may mean that the cardiopulmonary function is lower than expected; if the ratio is greater than 1, it may mean that the cardiopulmonary function is better. These two parts consider the differences between systolic and diastolic blood pressure and the target values ​​respectively. The systolic and diastolic blood pressure ranges provide a reference standard. By calculating the ratio of the difference to the range and squaring it, the degree of deviation of blood pressure from the target value is emphasized. If the blood pressure differs greatly from the target value, the squared value will increase, and the impact on CPI will also increase accordingly, indicating that there may be a risk of abnormal cardiopulmonary function. Postoperative infection may affect cardiopulmonary function. Incorporating the predicted postoperative infection index into the formula can comprehensively consider the impact of infection on cardiopulmonary function. If the risk of postoperative infection is high, the cardiopulmonary function index may be reduced. The formula comprehensively evaluates the patient's cardiopulmonary function by comprehensively considering the relationship between cardiac output and heart rate, the comparison between actual maximum oxygen uptake and predicted maximum oxygen uptake, and the difference between blood pressure and target value, and combining it with the predicted postoperative infection index. The calculation results of each part complement each other and together constitute the predicted cardiopulmonary function index, which can help doctors promptly detect the risk of abnormal cardiopulmonary function in patients, take appropriate treatment and intervention measures, and improve the quality and safety of patients' rehabilitation.

[0083] This formula comprehensively considers multiple key physiological indicators such as cardiac output, heart rate, actual maximum oxygen uptake, systolic blood pressure, diastolic blood pressure, and the postoperative infection index to comprehensively evaluate the patient's cardiopulmonary function and avoid the one-sidedness of a single indicator evaluation. Through the precise calculation of these indicators, it can timely discover potential risks of abnormal cardiopulmonary function and provide doctors with accurate diagnostic basis. The systolic and diastolic blood pressure target values ​​and the setting of predicted maximum oxygen uptake in the formula help doctors develop personalized treatment plans and rehabilitation plans for patients, adjust treatment strategies according to the specific circumstances of different patients, and improve treatment effects. Furthermore, combined with the postoperative infection index, it can comprehensively consider the impact of infection on cardiopulmonary function, take preventive and intervention measures in advance, and reduce the incidence of cardiopulmonary complications caused by infection. This formula helps to improve the postoperative management level of patients undergoing thoracic surgery, promote their rehabilitation, and improve their quality of life and prognosis.

[0084] In the preferred embodiment of the above-mentioned method for predicting abnormal postoperative indicators of thoracic surgery: calculating the postoperative infection index threshold The specific steps are: Historical data including historical postoperative infection index .

[0085] According to the historical postoperative infection index Calculation of postoperative infection index threshold , the specific formula is as follows:

[0086] in, Representative The postoperative infection index of each patient was The value of is 1, 2, 3, ... ; represents the total number of historical patient samples, Represents the mean value constant.

[0087] It should be noted that the calculation of the historical postoperative infection index The specific method is: by obtaining the historical preoperative examination data, historical basic information data, historical intraoperative data and historical postoperative recovery data of the patients in the historical cases, the historical preoperative comprehensive value, the historical basic information evaluation value, the historical intraoperative risk index and the historical postoperative recovery index are calculated through the above scheme, and the historical postoperative infection index of each patient is calculated. ; All historical postoperative infection indexes of historical patients are sorted and recorded according to the patient number to form a data set containing the postoperative infection indexes of all historical patients. For the first patient, the postoperative infection index is recorded as The second patient is Until the last patient Through the above steps, the historical postoperative infection index can be obtained from the historical data. .

[0088] By collecting a large amount of historical thoracic surgery patient data, statistically analyzing these historical data, and calculating the historical postoperative infection index of each patient According to the calculation method of the above formula, different constant values ​​are tried respectively to observe the degree of fit of the calculated postoperative infection index threshold to the historical data. The degree of fit is evaluated according to statistical indicators, such as mean square error, mean absolute error, etc., and the value that minimizes these statistical indicators is selected. The value is used as the final average constant .

[0089] Suppose we have a set of historical patient samples , that is, there are 10 historical patients' postoperative infection index data that need to be analyzed.

[0090] First, let's ignore the constant ,calculate , assuming that the postoperative infection indexes of these ten historical patients are , , , , , , , , , .

[0091] So .

[0092] The average postoperative infection index was .

[0093] Then calculate, for example, for the first patient: , calculate the values ​​of other patients in turn and sum them up. Assume that the total is Now try different constants For example, first take =1, the postoperative infection index threshold is calculated according to the formula, and the specific formula is as follows:

[0094] Take again =1.5, the specific formula is as follows:

[0095] The mean square error and mean absolute error are then used to evaluate the degree of fit, based on the following specific formula:

[0096] The calculation formula of mean square error is: is the actual postoperative infection index, According to the current The threshold prediction value calculated by the value is assumed to be the actual postoperative infection index of the ten patients. arrive , respectively calculate when =1 and =1.5, the mean square error, the mean absolute error is calculated as , perform the same calculation, if it is found that =1.2, the mean square error and mean absolute error are both the smallest, so choose =1.2 as the final average value constant .

[0097] This formula represents the sum of the postoperative infection index of all historical patients. Representative The postoperative infection index of the patients was From 1 to Traverse all historical patients, represents the total number of historical patient samples; The average value of the postoperative infection index of historical patients was calculated. This average value reflects the overall trend of postoperative infection levels of historical patients and provides a benchmark value for subsequent determination of thresholds. This step is to calculate the square of the difference between the postoperative infection index of each historical patient and the average infection index. The purpose is to highlight the degree of deviation of each patient's infection index from the overall average level. If a patient's infection index differs greatly from the average, the square of this difference will be larger, thus more significantly affecting the value of the standard deviation in subsequent calculations. The square of the above difference of all patients is summed up. By summing up, the total degree of deviation of all patients from the average infection index in the overall historical data can be obtained; The standard deviation was calculated. The standard deviation reflects the dispersion of the historical patients' postoperative infection index, that is, the fluctuation of the data. If the standard deviation is large, it means that the distribution of the historical patients' infection index is relatively dispersed and the difference is large; if the standard deviation is small, it means that the distribution of the infection index is relatively concentrated and the infection conditions between patients are relatively similar. Determine the postoperative infection index threshold, where Represents the mean value constant, which is The value obtained by multiplying the mean and standard deviation by a constant is the postoperative infection index threshold.

[0098] This formula can accurately determine the threshold of the postoperative infection index by analyzing the postoperative infection index of historical patients. This provides an objective standard for assessing the infection risk of new patients and avoids the uncertainty of subjective judgment. Doctors can quickly determine whether the patient is at a high risk of infection based on the threshold, so as to take preventive and intervention measures in time. The formula comprehensively considers the data of all historical patients, making the determination of the threshold more comprehensive and reliable. It not only reflects the overall average infection level, but also takes into account the discreteness of the data, and can adapt to the diversity of different patient groups. The introduction of constants increases the flexibility of the threshold. This formula helps to improve the postoperative management level of thoracic surgery, reduce the incidence of postoperative infection, promote patient recovery, reduce the waste of medical resources, and improve medical quality and patient satisfaction.

[0099] In the preferred embodiment of the above method for predicting abnormal postoperative indexes of thoracic surgery: calculating the threshold value of the cardiopulmonary function index The specific steps are: Historical data also includes historical ECG scores , historical echocardiographic scores and historical lung function scores .

[0100] Based on historical ECG scoring , historical echocardiographic scores and historical lung function scores Calculation of cardiopulmonary function index threshold , the specific formula is as follows:

[0101] in, For the Scoring of historical ECGs, The value of is 1, 2, 3, ... , Represents the total number of ECG parameter samples; For the Historical echocardiographic scores, The value of is 1, 2, 3, ... , represents the total number of cardiac ultrasound parameter samples; For the A historical lung function score, The value of is 1, 2, 3, ... , represents the total number of samples of lung function parameters; Representative ECG score The weight coefficient is 0.1< ≤0.3, Scoring cardiac ultrasound The weight coefficient is in the range of 0.3≤ ≤0.6, Scoring lung function The weight coefficient is 0.2≤ ≤0.5, and + + =1.

[0102] It should be noted that historical electrocardiogram scores The score is scored by the heart rate range of the electrocardiogram, whether it is normal sinus rhythm, and whether there are ST segment and T wave changes; if the total score is 00 points, the normal heart rate range is 60-100 beats / minute. If the heart rate is within this range, 30 points will be given; if the heart rate is 55-59 beats / minute or 101-105 beats / minute, 5 points will be deducted, and the score is 25 points; if the heart rate is 50-54 beats / minute or 106-110 beats / minute, 10 points will be deducted, and the score is 20 points; if the heart rate is lower than 50 beats / minute or higher than 110 beats / minute, 15 points will be deducted, and the score is 15 points. Normal sinus rhythm is scored 30 points. If atrial premature beats are less than 5 times per minute, 5 points will be deducted, and the score is 25 points; if atrial premature beats are 5-10 times per minute, 10 points will be deducted, and the score is 20 points; if ventricular premature beats are less than 5 times per minute, 8 points will be deducted, and the score is 22 points; if atrial fibrillation occurs, 20 points will be deducted, and the score is 10 points. No ST segment change is scored 20 points; if the ST segment is less than 0.5mm, 5 points will be deducted, and the score is 15 points; if the ST segment is 0.5-1mm, 10 points will be deducted, and the score is 10 points. No T wave change is scored 20 points; if the T wave is flat, 5 points will be deducted, and the score is 15 points; if the T wave is inverted, 10 points will be deducted, and the score is 10 points.

[0103] Assuming that a patient has a heart rate of 70 beats / min, normal sinus rhythm, and no ST segment and T wave changes, the total score of the patient's historical ECG score is 30+30+20+20=100 points. Assuming the weight coefficient =0.2, then the patient's electrocardiogram contribution in the formula is .

[0104] It should be noted that cardiac ultrasound scoring It is scored by scoring the cardiac ultrasound images. For example, if the left ventricular ejection is within the range of 50% to 70%, 40 points are scored; if the left ventricular ejection is between 45% and 49%, 5 points are deducted, and the score is 35 points; if the left ventricular ejection is between 40% and 44%, 10 points are deducted, and the score is 30 points; if the left ventricular ejection is less than 40%, 15 points are deducted, and the score is 25 points. The size of the heart chamber is within the normal range and 30 points are scored; if it is slightly enlarged or reduced, 5 points are deducted, and the score is 25 points; if it is moderately enlarged or reduced, 10 points are deducted, and the score is 20 points; if it is severely enlarged or reduced, 15 points are deducted, and the score is 15 points. No valvular disease is 30 points; if there is mild valvular stenosis or regurgitation, 5 points are deducted, and the score is 25 points; if there is moderate valvular stenosis or regurgitation, 10 points are deducted, and the score is 20 points; if there is severe valvular stenosis or regurgitation, 15 points are deducted, and the score is 15 points.

[0105] Assuming that a patient has a left ventricular ejection fraction of 65%, normal heart chamber size, and mild mitral regurgitation, the total score of the patient's echocardiography is 40+30+25=95 points. Assuming the weighting coefficient is =0.4, then the cardiac ultrasound contribution of this patient in the formula is .

[0106] If vital capacity is within the normal range, you will get 30 points; if it is less than 80% of the normal range, 5 points will be deducted, and the score will be 25 points; if it is less than 60% of the normal range, 10 points will be deducted, and the score will be 20 points; if it is less than 40% of the normal range, 15 points will be deducted, and the score will be 15 points. If the forced expiratory volume is within the normal range, you will get 30 points; if it is less than 80% of the normal range, 5 points will be deducted, and the score will be 25 points; if it is less than 60% of the normal range, 10 points will be deducted, and the score will be 20 points; if it is less than 40% of the normal range, 15 points will be deducted, and the score will be 15 points. If the maximum ventilation is within the normal range, you will get 40 points; if it is less than 80% of the normal range, 5 points will be deducted, and the score will be 35 points; if it is less than 60% of the normal range, 10 points will be deducted, and the score will be 30 points; if it is less than 40% of the normal range, 15 points will be deducted, and the score will be 25 points.

[0107] Assuming that a patient's vital capacity is 85% of the normal range, the forced expiratory volume is 80% of the normal range, and the maximum ventilation volume is 75% of the normal range, then the total score of the patient's lung function score is 25+25+35=85 points. Assuming the weight coefficient =0.3, then the lung function contribution of this patient in the formula is .

[0108] Representative Scoring of historical ECGs, Represents the total number of ECG parameter samples, summing all historical ECG scores Then divide by the total number of samples , get the average value of historical ECG parameters, multiply by the weight coefficient , which reflects the contribution of ECG parameters in the comprehensive assessment of the threshold of cardiopulmonary function index. ECG parameters can provide information about cardiac electrical activity, such as whether the heart rate is normal and whether there is arrhythmia, which is of great significance for the assessment of cardiopulmonary function; Representative Historical echocardiographic scores, Represents the total number of cardiac ultrasound parameter samples. First, calculate the average value of historical cardiac ultrasound parameters. , then multiply by the weight coefficient ,Cardiac ultrasound parameters can provide detailed information about cardiac structure and function, such as left ventricular ejection fraction, cardiac chamber size, etc., and play a key role in assessing cardiopulmonary function, so their weight is relatively high; Representative A historical lung function score, Represents the total number of lung function parameter samples, calculates the average value of the historical lung function parameters and multiplies it by the weight coefficient , pulmonary function parameters reflect the state of respiratory function, such as vital capacity, forced expiratory volume, etc., which are indispensable for the evaluation of overall cardiopulmonary function; the formula comprehensively considers historical electrocardiogram scores, historical cardiac ultrasound scores and historical pulmonary function scores, and assigns different weight coefficients to each of them, and then adds the values ​​of these three parts to obtain the cardiopulmonary function index threshold The weight coefficient is set according to the relative importance of each parameter in the assessment of cardiopulmonary function and meets the following requirements: + + =1, ensuring that the relative proportions of each part in the comprehensive evaluation are reasonable. The purpose of this formula is to use multiple parameters in historical data to comprehensively and accurately evaluate the normal range of cardiopulmonary function and provide a reference standard for determining whether the cardiopulmonary function of a new patient is abnormal. If the cardiopulmonary function index of a new patient exceeds this threshold range, it may indicate abnormal cardiopulmonary function and require further examination and treatment.

[0109] This formula takes into account the electrocardiogram score, cardiac ultrasound score and pulmonary function score, comprehensively reflects multiple important aspects of cardiopulmonary function, avoids the one-sidedness of single parameter evaluation, and through the analysis of historical data, can more accurately determine the threshold of cardiopulmonary function index, providing a reliable reference for doctors to evaluate the cardiopulmonary function status of patients. Different parameters are assigned different weight coefficients to make the evaluation more scientific and personalized. This formula helps to detect abnormal cardiopulmonary function early, take timely intervention measures, reduce the risk of postoperative complications, improve the safety and success rate of thoracic surgery, promote patient recovery, and improve the quality of medical care and the quality of life of patients.

[0110] In the preferred embodiment of the above-mentioned method for predicting abnormal postoperative indicators of thoracic surgery, the specific method for determining whether to trigger an infection warning is: Postoperative infection index threshold set Including the first threshold and secondary threshold ,in, < .

[0111] When predicting postoperative infection index ≤ When the infection warning is not triggered, routine postoperative management is formulated.

[0112] when <Prediction of postoperative infection index ≤ When the infection is detected, a first-level infection warning is triggered and an intermediate postoperative management and intervention strategy is formulated.

[0113] when <Prediction of postoperative infection index When the infection is detected, a secondary infection warning is triggered and advanced postoperative management and intervention strategies are formulated.

[0114] The method for determining whether the abnormal cardiopulmonary function warning is triggered is: Cardiopulmonary function index threshold set Including basic threshold and Advanced Threshold ,in, < .

[0115] When predicting cardiopulmonary function index ≤ When the patient is in emergency situation, cardiopulmonary function warning is not triggered and routine postoperative management is formulated.

[0116] when <Predicted cardiopulmonary function index ≤ When the patient is diagnosed with mild cardiopulmonary dysfunction, an early warning is triggered and enhanced postoperative management and intervention strategies are formulated.

[0117] when <Predicted cardiopulmonary function index When severe cardiopulmonary dysfunction occurs, an early warning is triggered and a special postoperative management and intervention strategy is formulated.

[0118] It should be noted that a large number of historical data of thoracic surgery patients were collected, including the patients' preoperative comprehensive value, basic information evaluation value, intraoperative risk index, postoperative recovery index, and whether postoperative infection occurred. According to the postoperative infection index in the historical data, the formula Calculate the postoperative infection index threshold set, where Representative The postoperative infection index of each patient was The value range is 1 to , is the average value constant. The first-level threshold is determined by statistical analysis of historical data. and secondary threshold ,in, < .

[0119] Collect historical data of patients including electrocardiogram scores, cardiac ultrasound scores and pulmonary function scores; according to the formula Calculate the threshold set of cardiopulmonary function index, Representative ECG score, Represents the total number of ECG parameter samples; Representative Cardiac ultrasound scores, represents the total number of cardiac ultrasound parameter samples; Representative Lung function scores, represents the total number of lung function parameter samples, , , are the weight coefficients of the corresponding parameters and + + =1, determine the basic threshold by analyzing historical data and Advanced Threshold ,in, < .

[0120] Postoperative infection index threshold: First level threshold : Represents a relatively low infection risk level. When the predicted postoperative infection index is less than or equal to It indicates that the patient's risk of infection is low and he is in a relatively safe state.

[0121] Secondary Threshold : Indicates a higher risk of infection. When the predicted postoperative infection index is greater than but less than or equal to When the predicted postoperative infection index is greater than Patients face a higher risk of infection.

[0122] When predicting postoperative infection index ≤ When the patient is undergoing surgery, routine postoperative care includes regularly observing the patient's vital signs, wound condition, drainage fluid, etc., keeping the wound clean, changing the dressing on time, and providing the patient with appropriate nutritional support to promote wound healing and physical recovery. Care is provided in accordance with the routine postoperative care process.

[0123] when <Prediction of postoperative infection index ≤ The intermediate postoperative management and intervention strategies under the first-level infection warning include strengthening the monitoring frequency of patients. In addition to vital signs and wound conditions, it is also necessary to pay close attention to the patient's laboratory test results. According to the specific conditions of the patients, it is necessary to adjust the antibiotic use plan to prevent the occurrence of infection. Increase the patient's nutritional intake and improve the body's immunity. Encourage patients to move appropriately to promote blood circulation, but avoid excessive fatigue.

[0124] when <Prediction of postoperative infection index The advanced postoperative management and intervention strategies under the second-level infection warning include immediate comprehensive examination and evaluation to determine the site and severity of the infection, bacterial culture and drug sensitivity testing to select the most effective antibiotic for treatment, strengthening patient isolation measures to prevent the spread of infection to other patients, and, if necessary, surgical intervention such as drainage of pus or removal of infected tissue.

[0125] Cardiopulmonary function index threshold: Basic threshold : Indicates a normal level of cardiopulmonary function. When the predicted cardiopulmonary function index is less than or equal to The patient's cardiopulmonary function was within the normal range.

[0126] Advanced Threshold : Indicates the risk of abnormal cardiopulmonary function. When the predicted cardiopulmonary function index is greater than but less than or equal to When the predicted cardiopulmonary function index is greater than Patients may have severe cardiopulmonary abnormalities.

[0127] When predicting cardiopulmonary function index ≤ When the patient is undergoing surgery, routine postoperative care includes regularly observing the patient's vital signs, wound condition, and drainage fluid, keeping the wound clean, changing the dressing on time, and providing the patient with appropriate nutritional support to promote wound healing and physical recovery. Follow the routine postoperative care process for care.

[0128] when <Predicted cardiopulmonary function index ≤ When a mild cardiopulmonary function abnormality warning is triggered, the enhanced postoperative management and intervention strategy includes increasing the monitoring of the patient's cardiopulmonary function, such as the frequency of electrocardiogram, cardiac ultrasound, pulmonary function test, etc. According to the patient's specific situation, the drug treatment plan needs to be adjusted, such as the use of drugs to improve heart function and bronchodilators, etc., and guiding patients to perform breathing training and moderate aerobic exercise to improve cardiopulmonary function.

[0129] when <Predicted cardiopulmonary function index When a severe cardiopulmonary dysfunction warning is triggered, the special postoperative management and intervention strategy includes immediately organizing a multidisciplinary consultation, including experts in cardiology, respiratory medicine, etc. to jointly assess the patient's condition, and taking emergency treatment measures if necessary, such as oxygen inhalation, use of a ventilator to assist breathing, and cardiotonic drug treatment. The patient's condition is closely monitored and the treatment plan is adjusted at any time.

[0130] By analyzing historical data to determine the threshold set, the judgment of postoperative infection and cardiopulmonary function abnormality is more scientific and accurate. Different levels of thresholds clearly divide the risk level, which helps doctors to detect potential problems in time. For postoperative infection, corresponding management strategies can be formulated according to different risk levels. Routine care is performed when the risk is low, monitoring and adjustment of treatment are strengthened for medium risk, and emergency intervention is taken for high risk, effectively reducing the incidence of infection. For cardiopulmonary function abnormalities, management can also be strengthened for mild abnormalities, and special measures can be taken for severe abnormalities to maximize the recovery of patients' cardiopulmonary function. The overall plan improves the pertinence and effectiveness of postoperative management of thoracic surgery, reduces the occurrence of complications, promotes faster and better recovery of patients, improves the quality of medical care and the quality of life of patients, and optimizes the allocation of medical resources, making medical services more efficient and accurate for patients.

[0131] The above embodiments may be implemented in whole or in part by software, hardware, firmware or any other combination thereof. When implemented using software, the above embodiments may be implemented in whole or in part in the form of a computer program product. A person of ordinary skill in the art may appreciate that the units and algorithm steps of each example described in conjunction with the embodiments disclosed herein may be implemented in electronic hardware or in combination with computer software and electronic hardware. Whether these functions are performed in hardware or software depends on the specific application and design constraints of the technical solution.

[0132] The above description is only a specific implementation manner of the present application, but the protection scope of the present application is not limited thereto. Any technician familiar with the technical field can easily think of changes or substitutions within the technical scope disclosed in the present application, which should be included in the protection scope of the present application.

Claims

1. A method for predicting abnormal postoperative indicators of thoracic surgery, characterized by: include: Obtain historical data of thoracic surgery and patients' preoperative examination data, basic information data, intraoperative data, and postoperative recovery data; Calculate the preoperative comprehensive value based on the preoperative examination data ; Calculate the basic information evaluation value based on the patient's basic information data ; Calculate the intraoperative risk index based on intraoperative data ; Calculate the postoperative recovery index based on the postoperative recovery data ; According to the preoperative comprehensive value , basic information evaluation value , intraoperative risk index Postoperative recovery index , calculate and predict postoperative infection index ; According to the postoperative recovery data and postoperative infection index Calculate the predicted cardiopulmonary function index ; Calculate postoperative infection index threshold based on historical data and cardiopulmonary function index threshold ; Postoperative infection index Threshold of postoperative infection index Compare and determine whether to trigger infection warning, formulate corresponding postoperative management and intervention strategies, and predict cardiopulmonary function index Cardiopulmonary function index threshold Make a comparison to determine whether an abnormal cardiopulmonary function warning is triggered and develop appropriate postoperative management and intervention strategies.

2. The method for predicting abnormal postoperative indicators of thoracic surgery according to claim 1, characterized in that: Calculate the preoperative comprehensive value The specific steps are: Preoperative examination data including white blood cell count , Red blood cell measured value , platelet measured value , minimum white blood cell count , maximum white blood cell count , minimum red blood cell value , maximum red blood cell , minimum platelet and platelet maximum ; According to the preoperative examination data, calculate the preoperative comprehensive value The specific formula is as follows: in, Representative white blood cell value The weight coefficient is 0.1< ≤0.3, The measured value of red blood cells The weight coefficient is in the range of 0.3≤ ≤0.6, Platelet count The weight coefficient is 0.2≤ ≤0.5, and + + =1.

3. The method for predicting abnormal postoperative indicators of thoracic surgery according to claim 2, characterized in that: Calculate the basic information evaluation value The specific steps are: Basic information data including age , Gender Rating , weight value and past medical history score ; Get the maximum age of patients undergoing thoracic surgery , minimum age , Maximum weight value And the minimum weight value ; According to the patient's basic information data and the maximum age , minimum age , Maximum weight value And the minimum weight value , calculate the basic information evaluation value The specific formula is as follows: in, For age The impact factor is 0.1≤ ≤0.3, Score Gender The impact factor is 0.2≤ ≤0.4, Weight value The impact factor is 0.3≤ ≤0.5, Scoring medical history The impact factor is 0.1< ≤0.3 and ; Representative A past medical history score, The value of is 1, 2, 3, ... , Represents the total number of past medical history scores.

4. The method for predicting abnormal postoperative indicators of thoracic surgery according to claim 3, characterized in that: Calculation of intraoperative risk index The specific steps are: Intraoperative data including surgical time factor value , intraoperative blood loss factor value , Anesthesia method factor value , anesthesia time factor value , Surgery type factor value And surgical instrument factor value ; Calculation of intraoperative risk index based on intraoperative data , the specific formula based on: 。 5. The method for predicting abnormal postoperative indicators of thoracic surgery according to claim 4, characterized in that: Calculation of postoperative recovery index The specific steps are: Postoperative recovery data including postoperative patient's vital sign factor values , drainage fluid factor value , Laboratory examination factor score , imaging examination factor values , pain assessment score and recovery status factor values ; Calculate the postoperative recovery index based on postoperative recovery data The specific formula is as follows: in, is the vital sign factor value The weight coefficient is 0.1≤ ≤0.3, Drainage fluid factor The weight coefficient is 0.2≤ ≤0.4, Scoring laboratory test factors The weight coefficient is 0.3≤ ≤0.4, is the imaging examination factor value The weight coefficient is 0.1< ≤0.3, Score the pain assessment The weight coefficient is 0.01< ≤0.05, Recovery factor value The weight coefficient is 0.01< ≤0.05 and .

6. The method for predicting abnormal postoperative indicators of thoracic surgery according to claim 5, characterized in that: Calculate the predicted postoperative infection index The specific steps are: According to the preoperative comprehensive value , basic information evaluation value , intraoperative risk index Postoperative recovery index , calculate and predict postoperative infection index The specific formula is as follows: in, Preoperative comprehensive value The weight coefficient is 0.1≤ ≤0.3, Basic information evaluation value The weight coefficient is 0.2≤ ≤0.4, Intraoperative risk index The weight coefficient is 0.3≤ ≤0.5, Postoperative recovery index The weight coefficient is 0.1< ≤0.3 and .

7. The method for predicting abnormal postoperative indicators of thoracic surgery according to claim 6, characterized in that: Calculate the predicted cardiopulmonary function index The specific steps are: Postoperative recovery data also includes cardiac output , heart rate , Actual VO2max , systolic blood pressure , diastolic blood pressure , Systolic blood pressure range and diastolic blood pressure range ; Setting a Systolic Blood Pressure Target , diastolic blood pressure target value and predicted VO2max ; According to the systolic blood pressure target , diastolic blood pressure target value , predicting VO2max , cardiac output , heart rate , Actual VO2max , systolic blood pressure , diastolic blood pressure , Systolic blood pressure range , diastolic blood pressure range Postoperative infection index , calculate and predict cardiopulmonary function index The specific formula is as follows: Among them, heart rate The value of >0; predicted VO2max The value of >0; systolic blood pressure range The value of >0; diastolic blood pressure range The value of >

0.

8. The method for predicting abnormal postoperative indicators of thoracic surgery according to claim 7, characterized in that: Calculation of postoperative infection index threshold The specific steps are: Historical data including historical postoperative infection index ; According to the historical postoperative infection index Calculation of postoperative infection index threshold The specific formula is as follows: in, Representative The postoperative infection index of each patient was The value of is 1, 2, 3, ... ; represents the total number of historical patient samples, Represents the mean value constant.

9. The method for predicting abnormal postoperative indicators of thoracic surgery according to claim 8, characterized in that: Calculation of cardiopulmonary function index threshold The specific steps are: Historical data also includes historical ECG scores , historical echocardiographic scores and historical lung function scores ; Based on historical ECG scoring , historical echocardiographic scores and historical lung function scores Calculation of cardiopulmonary function index threshold The specific formula is as follows: in, For the ECG score, The value of is 1, 2, 3, ... , Represents the total number of ECG parameter samples; For the Cardiac ultrasound scores, The value of is 1, 2, 3, ... , represents the total number of cardiac ultrasound parameter samples; For the Lung function scores, The value of is 1, 2, 3, ... , represents the total number of samples of lung function parameters; Representative ECG score The weight coefficient is 0.1< ≤0.3, Scoring cardiac ultrasound The weight coefficient is in the range of 0.3≤ ≤0.6, Scoring lung function The weight coefficient is 0.2≤ ≤0.5, and + + =1.

10. The method for predicting abnormal postoperative indicators of thoracic surgery according to claim 9, characterized in that: The specific method for determining whether an infection warning is triggered is: Postoperative infection index threshold set Including the first threshold and secondary threshold ,in, < ; When predicting postoperative infection index ≤ When the infection warning is not triggered, routine postoperative management is formulated; when <Prediction of postoperative infection index ≤ When the infection is detected, a first-level infection warning is triggered and an intermediate postoperative management and intervention strategy is formulated; when <Prediction of postoperative infection index When the infection is detected, a secondary infection warning is triggered and advanced postoperative management and intervention strategies are formulated; The method for determining whether the abnormal cardiopulmonary function warning is triggered is: Cardiopulmonary function index threshold set Including basic threshold and Advanced Threshold ,in, < ; When predicting cardiopulmonary function index ≤ When the patient is in the hospital, the cardiopulmonary function warning is not triggered and routine postoperative management is formulated; when <Predicted cardiopulmonary function index ≤ When the patient is in the hospital, it will trigger an early warning of mild abnormal cardiopulmonary function and formulate enhanced postoperative management and intervention strategies; when <Predicted cardiopulmonary function index When severe cardiopulmonary dysfunction occurs, an early warning is triggered and a special postoperative management and intervention strategy is formulated.

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