基于Nomogram预测模型探讨致心脏围术期患者外周静脉炎相关因素的研究  

Study of factors associated with peripheral phlebitis in the perioperative cardiac period based on Nomogram prediction model

作　　者：汪文婧 方园园 韩梅 程光存 吴源[1] Wang Wenjing;Fang Yuanyuan;Han Mei;Cheng Guangcun;Wu Yuan(Department of Public Health,Anhui Medical University,Hefei 230032,China;不详)

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]中国科学技术大学附属第一医院(安徽省立医院)心脏大血管外科

出　　处：《中国临床保健杂志》2022年第2期269-273,共5页Chinese Journal of Clinical Healthcare

基　　金：安徽省重点研究与开发计划项目(202004j07020018)。

摘　　要：目的筛选出心脏外科围术期患者导致静脉炎的危险因素,并建立Nomogram预测模型,为预防静脉炎发生提供依据。方法回顾性分析2019年1—12月中国科学技术大学附属第一医院心脏外科综合病区的178例经外周静脉置管的成人患者临床资料,记录发生外周静脉炎的患者相关资料,利用最小绝对值收缩和选择算子(LASSO)回归分析法筛选出重要风险因素,建立Nomogram风险预测临床模型,并给出一致性指数(C-index)和校准曲线。结果178例经外周静脉置管者中117例发生静脉炎。将研究的24个潜在静脉炎相关因素进行LASSO回归分析,结果显示术前用药、使用血管活性药物尤其是去甲肾上腺素、使用血管活性药物种类数、使用抗凝剂、使用艾司洛尔是患者发生外周静脉炎的高危因素,以此建立的列线图模型C指数是0.79(95%CI:0.68~0.83)。结论构建的导致心脏围术期患者产生外周静脉炎的Nomogram模型具有一定的临床应用价值,能够个体化预测患者外周静脉炎的发生。Objective To screen out the risk factors of phlebitis in perioperative cardiac surgery patients and establish a Nomogram prediction model to provide a basis for the prevention of phlebitis.Methods The clinical data of 178 patients with peripheral venous catheterization in the Cardiac Surgery Ward of the First Affiliated Hospital of University of Science and Technology of China from January to December 2019 were retrospectively analyzed.The patients with peripheral phlebitis were recorded,and the least absolute value shrinkage selection algorithm(Lasso)regression analysis was used to screen out the important risk factors,and then establish a Nomogram risk prediction model,clinical and consistency index(C-index)is given and the calibration curve.Results One hundred and seventeen of 178 patients with catheterization developed phlebitis.Lasso regression analysis was performed on 24 potential phlebitis-related factors in the study,the results showed whether preoperative medication,whether to use vasoactive medications,using vascular active drug kinds,whether to use anticoagulation therapy,whether to use norepinephrine,whether to use esmolol are risk factors of phlebitis in patients,The C index for the nomogram of model was 0.79(95%CI:0.68-0.83).Conclusions Nomogram model of peripheral phlebitis in perioperative cardiac patients could be used to individually predict the occurrence of peripheral phlebitis.

关 键 词：静脉炎 心血管外科手术 围手术期 模型 统计学 预测 

分 类 号：R654.2[医药卫生—外科学]