基于随机森林算法的心电图引导手臂输液港静脉导管头端精准定位的影响因素研究  

A study on influence factors of accurate positioning of venous catheter tip in arm infusion port guided by electrocardiogram based on random forest algorithm

作　　者：徐湘妍玉 吉昕宇 宋昀杰 徐晓霜 徐海萍 张汝阳 XU Xiangyanyu;JI Xinyu;SONG Yunjie;XU Xiaoshuang;XU Haiping;ZHANG Ruyang(Department of Biostatistics,School of Public Health of Nanjing Medical University,Nanjing,Jiangsu,211166;Department of Epidemiology and Biostatistics,School of Public Health of Fudan University,Shanghai,200032;Department of Breast Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210036)

机构地区：[1]南京医科大学公共卫生学院生物统计学系,江苏南京211166 [2]复旦大学公共卫生学院流行病与卫生统计学系,上海200032 [3]南京医科大学第一附属医院乳腺科,江苏南京210036

出　　处：《实用临床医药杂志》2021年第19期7-11,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省妇幼健康科研项目(F201821);江苏省自然科学基金面上项目(BK20191354);江苏省人民医院“临床能力提升工程”(JSPH-NB-2020-5);南京医科大学护理研究中心肿瘤护理研究分中心开放课题(NYZLKF-2-202104)。

摘　　要：目的基于随机森林算法探讨心电图技术引导手臂输液港静脉导管头端精准定位的影响因素。方法选取338例植入输液港的女性乳腺癌化疗患者作为研究对象,应用心电图引导静脉导管头端定位,并采集患者的相关信息。采用随机森林方法探讨心电图引导手臂输液港静脉导管头端精准定位的影响因素,应用分类树拟合导管头端定位精准性模型。结果身高、体质量和年龄与导管头端定位精准性相关。所构建模型的准确率(0.84)、灵敏度(0.98)、阳性预测值(0.85)尚可,特异度(0.19)、阴性预测值(0.54)、曲线下面积(AUC)(0.67)较低。结论临床人员应着重关注低身高(<155 cm)、高体质量(>52 kg)、年龄49~63岁的乳腺癌患者,因为此类患者易发生静脉导管头端定位不精准的情况。Objective To explore influence factors of accurate positioning of venous catheter tip in arm infusion port guided by electrocardiogram based on random forest algorithm.Methods A total of 338 female breast cancer patients with chemotherapy implanted in transfusion port were selected as research objects.Electrocardiogram was used to guide the positioning of the venous catheter tip,and relevant information of the patients was collected.Random forest method was used to explore the influencing factors of electrocardiogram guided precise positioning of intravenous catheter tip in arm infusion port,and classification tree was used to fit the precise positioning model of catheter tip.Results Height,weight and age were significantly associated with the accuracy of catheter head positioning.The accuracy(0.84),sensitivity(0.98),positive predictive value(0.85)of the constructed model were acceptable,and the specificity(0.19),negative predictive value(0.54)and area under the Curve(AUC)(0.67)were low.Conclusion Clinical staffshould pay attention to breast cancer patients with low height(<155 cm),high body mass(>52 kg)and age of 49 to 63 years,because such patients are prone to occur inaccurate positioning of the head of venous catheter.

关 键 词：随机森林 心电图 手臂输液港 静脉导管定位 影响因素 

分 类 号：R473.73[医药卫生—护理学] R195.1[医药卫生—临床医学]