急性脑出血患者置入胃管的预测因素及模型建立  

Predictors factors and model establishment of gastric tube placement in patients with acute cerebral hemorrhage

作　　者：张毅[1] 刘颖[1] 郭金竹[1] Zhang Yi;Liu Ying;Guo Jinzhu(Neurosurgery Department,Beijing Union Hospital,Beijing 100730,China)

机构地区：[1]北京协和医院神经外科,100730

出　　处：《中国实用护理杂志》2020年第28期2203-2208,共6页Chinese Journal of Practical Nursing

摘　　要：目的筛选急性脑出血患者置入胃管的预测因素,构建急性脑出血患者置入胃管的预测模型并分析其诊断效能。方法选取2007年5月至2019年5月北京协和医院收治的1425例急性脑缺血患者作为研究对象。根据患者入院后是否置入胃管将患者分为置入胃管组(观察组)135例和未置入组(对照组)1290例。采用Logistic回归分析影响急性脑出血置入胃管的预测因素,并构建急性脑出血患者置入胃管的预测模型。采用受试者工作特征曲线(ROC)分析闭塞性脑积水+疾病严重程度+标准吞咽功能量表(SSA)分级+接受吞咽试验(模型A)预测急性脑出血患者置入胃管的效能。结果2组在学历、居住地、脑室内出血、闭塞性脑积水、痴呆、心力衰竭、心理反应、SSA分级、疾病严重程度、接受吞咽实验方面比较,差异有统计学意义(χ2值为10.182~99.194,P<0.05)。Logistic回归分析结果显示闭塞性脑积水、疾病严重程度、SSA分级、接受吞咽实验与急性脑出血患者置入胃管密切相关。模型A预测急性脑出血患者置入胃管的曲线下面积、敏感度、特异度分别为0.874、77.78%、89.30%。结论急性脑出血患者闭塞性脑积水、疾病严重程度、SSA分级、接受吞咽实验与置入胃管关系密切,四者构建的模型可以预测患者置入胃管的风险,且效能较高。Objective To screen the predictive factors of gastric tube placement in patients with acute cerebral hemorrhage,and to construct a predictive model of gastric tube placement in patients with acute cerebral hemorrhage and analyze its diagnostic efficacy.Methods A total of 1425 patients with acute cerebral ischemia admitted to PMUCH from May 2007 to May 2019 were selected as subjects.The patients were divided into the gastric tube group(observation group,n=135)and the unimplanted group(control group,n=1290)according to whether the patient was placed in the stomach tube after admission.Logistic regression was used to analyze the predictive factors affecting the placement of gastric tube in patients with acute cerebral hemorrhage,and to construct a predictive model for the placement of gastric tube in patients with acute cerebral hemorrhage.The receiver operating characteristic curve(ROC)was used to analyze the occlusive hydrocephalus+severity of disease+standardized swallowing assessment(SSA)grade+swallowing test(model A)to predict the efficacy of placement of gastric tube in patients with acute cerebral hemorrhage.Results There were significant differences between the two groups in terms of education,residence,intraventricular hemorrhage,occlusive hydrocephalus,dementia,heart failure,psychological reaction,SSA classification,disease severity,and swallowing test(χ2 value was 10.182-99.194,P<0.05).Logistic regression analysis showed that the occlusive hydrocephalus,severity of disease,SSA grade,and swallowing test were closely related to the placement of gastric tube in patients with acute cerebral hemorrhage.The area under the curve(AUC),sensitivity,and specificity of model A in predicts that placement of gastric tube in patients with acute cerebral hemorrhage were 0.874,77.78%,and 89.30%,respectively.Results The occlusive hydrocephalus,severity of disease,SSA grade,and swallowing test were closely related to the placement of gastric tube in patients with acute cerebral hemorrhage.The model constructed by the four

关 键 词：急性脑出血 置入胃管 预测因素 模型 

分 类 号：R473.74[医药卫生—护理学]