Nomogram预测模型分析早产儿PICC置管并发静脉炎症的风险  

Nomogram forecasting model to analyze the risk of premature PICC catheter concurrent phlebitis

作　　者：韩莹[1] 李娜 HAN Ying;LI Na(Department of Pediatrics,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101149;Department of Neonatology,Beijing Maternal and Child Health Care Hospital of Tongzhou District,Beijing 101100,China)

机构地区：[1]首都医科大学附属北京潞河医院儿科病区,北京101149 [2]北京市通州区妇幼保健院新生儿科,北京101100

出　　处：《川北医学院学报》2019年第2期309-312,共4页Journal of North Sichuan Medical College

基　　金：北京市通州区科技计划项目(KJ2018CX009-36)

摘　　要：目的:分析早产儿外周导入中心静脉置管(PICC)并发静脉炎症的风险因素,并建立Nomogram预测模型,为其临床防治提供依据。方法:回顾性分析PICC置管的150例早产儿的临床资料,其中16例发生静脉炎症,采用单因素分析和多因素Logistic回归分析诱发静脉炎症的危险因素,R软件建立Nomogram预测模型,ROC曲线分析该模型的应用价值。结果:经Logistic回归分析,胎龄<32周、穿刺次数≥2次、置管时间>2个月、导管移位和渗血刺激均为引发静脉炎的危险因素(OR>1,P<0.05)。以危险因素建立列线图模型,穿刺次数每增加1次,风险评分增加7.3分;胎龄每减少1周,风险评分增加7.1分;置管时间每增加1周,风险评分增加14.5分;合并导管移位会使风险值增加21.8分;合并渗血刺激会使风险值增加15.7分。列线图模型内部验证C-index=0.795,精度良好;ROC曲线分析结果证实列线图模型的评估价值较高[AUC=0.827(CI%0.761～0.893)]。结论:基于危险因素建立的列线图模型对早产儿PICC置管并发静脉炎具有良好的预测价值。Objective:To analyze the risk of factors of phlebitis of premature after PICC catheter,and establish the Nomogram prediction model,so as to provide the basis for its clinical prevention and treatment. Methods:The clinical data of 150 premature infants had concurrent PICC catheterization were analyzed retrospectively,Among which 16 cases had venous inflammation.Univariate analysis and multivariate Logistic regression were used to analyze the risk factors of venous inflammation.Nomogram prediction model is established by using R software,and ROC curve analysis was used to analyze its application value. Results:Logistic regression analysis showed that gestational age<32 weeks,puncture frequency ≥2 times,catheterization time >2 months,catheter displacement and osmolar stimulation were all risk factors for phlebitis ( OR>,P < 0.05).The nomogram model established by risk factors showed the risk score increased by 7.3 points for each additional puncture,7.1 points for each week of gestational age reduction,14.5 points for each week of catheterization time increase,21.8 points with catheter displacement and 15.7 points with osmolar stimulation.C-index=0.795 was verified internally by the nomogram model with good accuracy;ROC curve analysis results confirmed that the evaluation value of the nomogram model was good ( AUC =0.827[CI% 0.761-0.893]). Conclusion:The nomogram model based on risk factors has a good predictive value for preterm infants with phlebitis after PICC catheterization.

关 键 词：外周导入中心静脉置管 静脉炎症 列线图模型 

分 类 号：R472[医药卫生—护理学]