上尿路结石术后患者留置双J管出院风险预测模型的构建研究  

Construction of Discharge Risk Prediction Model for Patients with Indwelled Double J Tubes after Upper Urinary Tract Calculi Operation

作　　者：吴伟霞[1,2] 张一鸣 何宗斌[2] 黄静文 申海燕 WU Wei-xia;ZHANG Yi-ming;HE Zong-bin;HUANG Jing-wen;SHEN Hai-yan(Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China;School of Nursing,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学珠江医院,广东广州510282 [2]南方医科大学护理学院,广东广州510515

出　　处：《护理学报》2022年第4期64-68,共5页Journal of Nursing（China）

基　　金：国家自然科学基金青年项目(81802516)。

摘　　要：目的探索上尿路结石术后留置双J管患者出院风险的危险因素并建立Logistic回归预测模型。方法选取2020年1—12月在广州市某三级甲等医院进行上尿路结石术后留置双J管435例患者为研究对象,根据留置输尿管支架症状分为阳性组(n=207)和阴性组(n=228),将2组各项指标进行对比,通过Logistic回归分析建立上尿路结石术后留置双J管出院患者风险预测模型,通过ROC曲线验证模型预测效果。结果本研究逐步回归分析显示每日饮水量、高血压、糖尿病、术后结石残留、术前尿白细胞定量为独立危险因素,构建风险预测模型。本模型的AUC值0.906,当临界值为-0.17时,灵敏度为0.848,特异度为0.832。结论本模型预测效果良好,具有一定的临床应用价值。该模型的应用可以为临床医护人员预测上尿路结石术后留置双J管患者出院风险提供客观参考依据。Objective To investigate the risk factors of discharge of patients with indwelled double J tubes after upper urinary tract calculi operation,and establish a logistic regression prediction model.Methods A total of 435patients with indwelled double J tubes after upper urinary tract calculi operation in a hospital in Guangzhou from January to December in2020 were selected.The patients were divided into positive group with ureteral stent-related symptoms(n=207)and negative group without symptoms(n=228)and the clinical indicators of the both group were compared.Logistic regression analysis was used to establish a risk prediction model for discharged patients with indwelled double J tubes after upper urinary tract calculus surgery,and the prediction effect of the model was verified by ROC curve.Results Five independent risk factors including daily water intake,hypertension,diabetes,pre-operative urinary leukocyte numbers and stone residue were identified according to the stepwise regression analysis.We also constructed a risk prediction model base on five factors.The AUC of this model was 0.906,and when the critical value was-0.17,the sensitivity and the specificity were 0.842 and 0.832,respectively.Conclusion With good predictive effect,the prediction model constructed in the study has clinical application value and provides reference to predict the discharge risk of patients with indwelled double J tubes after upper urinary tract calculus surgery.

关 键 词：上尿路结石 双J管 输尿管支架管 预测模型 输尿管支架相关症状 

分 类 号：R473.6[医药卫生—护理学]