主动脉手术患者术中压力性损伤Nomogram预测模型的建立  

Establish of Nomogram prediction model for intraoperative pressure injury in patients undergoing aortic surgery

作　　者：董瑶 宋玲[2] Dong Yao;Song Ling(Operating Room,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100010,China;Operating Room,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京朝阳医院手术室,100010 [2]首都医科大学附属北京安贞医院手术室,100029

出　　处：《中华现代护理杂志》2021年第18期2453-2458,共6页Chinese Journal of Modern Nursing

摘　　要：目的建立成人主动脉手术患者术中压力性损伤的Nomogram预测模型,并检验模型的有效性。方法采用便利抽样的方法选取2016年7月—2017年3月在北京安贞医院手术室进行主动脉手术的患者400例,应用主动脉手术患者术中压力性损伤危险因素调查表收集资料。主动脉手术患者术中压力性损伤的危险因素采用多因素Logistic回归分析,建立Nomogram模型,并采用ROC曲线验证模型预测的准确性。结果研究共收集样本400例,发生术中压力性损伤167例,发生率为41.75%。术前绝对卧床、术中深低温停循环、术中使用去甲肾上腺素、肾上腺素、多巴胺、术中受压部位浸湿是主动脉手术患者术中压力性损伤的危险因素(P<0.05)。以此建立Nomogram模型,C-index值为0.786,ROC曲线下面积为0.785,灵敏度为73.65%,特异度为68.67%。结论主动脉手术患者术中压力性损伤的Nomogram模型可以准确预测此类患者术中压力性损伤的发生风险,预测方法便捷、可操作性强、结果直观,便于临床护士快速、准确判断主动脉手术患者发生术中压力性损伤的风险。Objective To establish a Nomogram prediction model for intraoperative pressure injury in adult patients undergoing aortic surgery and test validity of the model.Methods The convenient sampling method was used to select 400 patients who underwent aortic surgery in Operating Room of Beijing Anzhen Hospital from July 2016 to March 2017.A questionnaire on risk factors for intraoperative pressure injury in patients undergoing aortic surgery was used to collect data.The risk factors of intraoperative pressure injury in patients undergoing aortic surgery were analyzed by multivariate Logistic regression,a Nomogram model was established and the ROC curve was used to verify the accuracy of the model prediction.Results A total of 400 samples were collected in the study and 167 cases of intraoperative pressure injury occurred,with an incidence rate of 41.75%.Preoperative strict bed rest,deep hypothermic circulatory arrest,intraoperative use of norepinephrine,epinephrine and dopamine and intraoperative compressional site infiltration were risk factors for intraoperative pressure injury in patients undergoing aortic surgery(P<0.05).Based on this,the Nomogram model was established.The C-index value was 0.786,the area under the ROC curve was 0.785,the sensitivity was 73.65%,and the specificity was 68.67%.Conclusions The Nomogram model can accurately predict the risk of intraoperative stress injury in such patients.The prediction method is convenient,operable and intuitive,which is convenient for clinical nurses to quickly and accurately judge the risk of intraoperative pressure injury in patients undergoing aortic surgery.

关 键 词：主动脉疾病 监测 手术中 危险因素 压力性损伤 Nomogram预测模型 

分 类 号：R473.6[医药卫生—护理学]