新生儿窒息并发胃肠功能损害的预测列线图模型构建  

Construction of a nomograph model for neonatal asphyxia complicated by gastrointestinal impairment

作　　者：徐鑫祺 闫静[1] 王增芹 Xu Xinqi;Yan Jing;Wang Zengqin(Xuzhou Maternal and Child Health Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市妇幼保健院,徐州221000

出　　处：《广西医科大学学报》2022年第10期1611-1616,共6页Journal of Guangxi Medical University

基　　金：江苏省妇幼健康科研项目(No.F202064)。

摘　　要：目的:探讨新生儿窒息并发胃肠功能损害的危险因素,并构建风险预测列线图模型。方法:回顾性分析本院2020年8月至2021年8月收治的127例窒息新生儿的临床资料。分析新生儿窒息并发胃肠功能损害的危险因素,并建立预测列线图模型。采用受试者工作特征(ROC)曲线和校准曲线评估列线图模型的预测效能、区分度和校准度。结果:127例窒息新生儿中并发胃肠功能损害的发生率为35.43%;单因素和多因素分析结果显示,胎龄小、低出生体重、重度窒息、宫内窘迫、脐带异常和羊水污染均是新生儿窒息并发胃肠功能损害的危险因素(P<0.05)。将上述危险因素作为预测指标,构建新生儿窒息并发胃肠功能损害的预测列线图模型,ROC曲线分析结果显示,列线图预测新生儿窒息并发胃肠功能损害的曲线下面积(AUC)为0.797(95%CI:0.723~0.858),灵敏度为71.79%,特异度为85.32%;Bootstrap自抽样法内部检验的一致性指数为0.795,该列线图模型区分度良好,校准曲线与标准曲线贴合较好。结论:胎龄小、低出生体重、重度窒息、宫内窘迫、脐带异常和羊水污染均是新生儿窒息并发胃肠功能损害的危险因素,据此构建的列线图模型对新生儿窒息并发胃肠功能损害的风险具有良好预测效能。Objective:To investigate the risk factors of neonatal asphyxia complicated by gastrointestinal impairment and to construct a nomograph model for risk prediction.Methods:The clinical data of 127 asphyxiated neonates admitted to our hospital from August 2020 to August 2021 were retrospectively analyzed.Risk factors for neonatal asphyxia complicated by gastrointestinal impairment were analyzed,and a nomograph model was constructed.The predictive efficacy,discrimination,and calibration of the nomograph model were assessed using receiver operating characteristic(ROC)curves and calibration curves.Results:The incidence of gastrointestinal impairment in 127 asphyxiated neonates was 35.43%;univariate and multifactorial analyses showed that low gestational age,low birth weight,severe asphyxia,intrauterine distress,umbilical cord abnormality and amniotic fluid contamination were risk factors for gastrointestinal impairment in neonates with asphyxia(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)for predicting gastrointestinal impairment in neonates with asphyxia was 0.797(95%CI:0.723-0.858),with a sensitivity of 71.79%and a specificity of85.32%.Internal validation using bootstrap showed a consistency of 0.795,the nomograph model was well differentiated,and the calibration curve fitted well with the standard curve.Conclusion:Low gestational age,low birth weight,severe asphyxia,intrauterine distress,umbilical cord abnormality and amniotic fluid contamination are all risk factors for neonatal asphyxia complicated by gastrointestinal impairment,and the nomograph model constructed accordingly has good predictive efficacy for the risk of neonatal asphyxia complicated by gastrointestinal impairment.

关 键 词：新生儿 窒息 胃肠功能损害 危险因素 

分 类 号：R722.12[医药卫生—儿科]