基于Logistic回归模型风险预测的护理模式对妇科腹腔镜术后胃肠蠕动功能恢复及生活质量的影响  

Effect of nursing model based on risk prediction with Logistic regression model on recovery of gastrointestinal motility function and quality of life in patients after gynecological laparoscopy

作　　者：陈琳 曹莉莉[1] 陈素华[1] Lin Chen;Li-Li Cao;Su-Hua Chen(Department of Obstetrics and Gynecology,People’s Hospital of Pan’an County,Jinhua 322300,Zhejiang Province,China)

机构地区：[1]浙江省磐安县人民医院妇产科,浙江省金华市322300

出　　处：《世界华人消化杂志》2022年第7期327-335,共9页World Chinese Journal of Digestology

摘　　要：背景腹腔镜手术是妇科常见治疗手段,虽为典型的微创术式,但术后并发症依然存在,影响术后早期康复.Logistic回归模型的构建可得到自变量的权重,了解腹腔镜术后并发症发生的危险因素,以此为导向制定干预措施.目的本研究以风险预测为切入点,通过观察妇科腹腔镜患者术后早期恢复情况、胃肠蠕动功能及生活质量,评价基于Logistic回归模型风险预测的护理模式对妇科腹腔镜患者术后恢复情况的影响,以探究基于Logistic回归模型风险预测的护理模式的有效性、可行性,为进一步提升妇科腹腔镜患者术后早期恢复质量提供数据支持和参考.方法选取2019-01/2021-01我院232例实施妇科腹腔镜患者的病例资料,构建Logistic回归模型预测妇科腹腔镜术后胃肠功能紊乱的独立危险因素及发生风险.前瞻性选取98例拟行妇科腹腔镜手术患者,根据入院建档顺序,以1:1配对原则分组,各49例.对照组采取常规护理,观察组采取基于Logistic回归模型风险预测的护理模式.观察比较2组术后恢复情况(首次排气时间、首次排便时间、肠鸣音恢复时间及胃肠蠕动开始时间)、生活质量.结果232例行妇科腹腔镜患者中,术后胃肠功能紊乱发生率38.36%;构建Logistic回归模型显示,年龄≥60岁、术后开始活动时间≥3 d、引流管留置时间≥7 d、术后血钾异常、术后无镇痛、术后未使用胃肠动力药物是妇科腹腔镜术后发生胃肠功能紊乱的独立危险因素(P<0.05);根据预测值和真实值绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),当Logistic(P)>0.209时,AUC为0.859,预测敏感度为95.92%,特异度为93.27%;观察组首次排气、首次排便、肠鸣音恢复及胃肠蠕动开始时间均短于对照组,差异有统计学意义(P<0.05);干预后观察组生活质量高于对照组,差异有统计学意义(P<0.05).结论基于Logistic回归模型风险预测的护理模式根�BACKGROUND Laparoscopic surgery is a common treatment in gynecology.Although it is a typical minimally invasive procedure,postoperative complications still exist and affect early postoperative recovery.Logistic regression models can be developed to obtain the weights of independent variables and to understand the risk factors for postoperative complications after laparoscopy,which can help to develop intervention strategies.AIM To evaluate the effect of a nursing model based on the risk prediction with a Logistic regression model on the early postoperative recovery,gastrointestinal motility,and quality of life in patients after gynecological laparoscopy.METHODS The case data of 232 patients undergoing gynecological laparoscopy at our hospital from January 2019 to January 2021 were selected to construct a Logistic regression model to predict the independent risk factors and incidence of gastrointestinal dysfunction after gynecological laparoscopy.Ninety-eight patients who would undergo gynecological laparoscopic surgery were prospectively selected and divided into either a control group or an observation group according to the order in which they were filed,with 49 cases in each group.The control group was given routine care,and the observation group adopted a care model based on the risk prediction using the Logistic regression model.The postoperative recovery status(time to first exhaust,time to first defecation,time to recovery of bowel sounds,and time to gastrointestinal peristalsis)and quality of life were compared between the two groups.RESULTS Among 232 patients undergoing gynecological laparoscopy,the incidence of postoperative gastrointestinal dysfunction was 38.36%.Logistic regression analysis showed that age≥60 years old,time to postoperative start of activity≥3 d,drainage tube indwelling time≥7 d,abnormal postoperative potassium,no use of postoperative analgesia,and no use of postoperative gastrointestinal motility drugs were independent risk factors for gastrointestinal dysfunction after gynecol

关 键 词：LOGISTIC回归模型 胃肠蠕动功能 生活质量 术后恢复 

分 类 号：R473.71[医药卫生—护理学]