脑出血患者便秘风险预测模型的构建与验证  

Construction and validation of risk prediction model for constipation in patients with cerebral hemorrhage

作　　者：张慧杰 刘莉[2] 马莎莎[3] 刘立云[3] 孙敏敏 王鲁繁 董海丽 Zhang Huijie;Liu Li;Ma Shasha;Liu Liyun;Sun Minmin;Wang Lufan;Dong Haili(School of Nursing,Binzhou Medical College,Binzhou 256600,China;Department of Nursing,Affiliated Hospital of Binzhou Medical College,Binzhou 256600,China;Department of Neurosurgery,Affiliated Hospital of Binzhou Medical College,Binzhou 256600,China;Department of Neurology,Affiliated Hospital of Binzhou Medical College,Binzhou 256600,China;Department of Neurosurgical ICU,Affiliated Hospital of Binzhou Medical College,Binzhou 256600,China)

机构地区：[1]滨州医学院护理学院,滨州256600 [2]滨州医学院附属医院护理部,滨州256600 [3]滨州医学院附属医院神经外科,滨州256600 [4]滨州医学院附属医院神经内科,滨州256600 [5]滨州医学院附属医院神经外科监护室,滨州256600

出　　处：《中国实用护理杂志》2023年第29期2285-2291,共7页Chinese Journal of Practical Nursing

基　　金：滨州医学院护理学院研究生科研创新支持计划(HYCX2022-015);滨州医学院附属医院护理"培优项目"(BYFYHL-PY202207)。

摘　　要：目的探讨脑出血患者发生便秘的影响因素,构建风险预测模型,并验证该模型的预测效果,从而科学指导后续的治疗和护理。方法采用前瞻性队列研究,便利抽样法选择2022年5—11月在滨州医学院附属医院住院的脑出血患者254例作为建模组,按照是否发生便秘分为便秘组(n=150)和非便秘组(n=104),利用单因素分析和Logistic回归分析脑出血患者发生便秘的影响因素,建立风险预测模型并绘制列线图。选取2022年12月至2023年3月在同一医院住院的110例脑出血患者作为验证组,采用Hosmer-Lemeshow检验和ROC曲线对模型进行验证。结果本研究最终纳入住院时间、洼田饮水试验评分、营养、利尿剂4个危险因素构建风险预测模型,建模组ROC曲线下面积为0.918,95%CI为0.848~0.963,最佳临界值为0.7225,灵敏度为0.885,特异度为0.837。外部验证结果显示,灵敏度为0.926,特异度为0.611。结论本研究构建的风险预测模型效果良好,可为临床评估脑出血患者是否存在便秘风险提供借鉴。Objective To investigate the influencing factors of constipation in patients with cerebral hemorrhage,construct a risk prediction model,and verify the predictive effect of the model to scientifically guide subsequent treatment and nursing.Methods A total of 254 patients with cerebral hemorrhage hospitalized in Affiliated Hospital of Binzhou Medical Collegefrom May 2022 to November 2022 were selected in a prospective cohort study,and they were divided into constipation group(n=150)and non-constipation group(n=104)according to whether constipation occurred.Univariate analysis and logistic regression were used to analyze the influencing factors of constipation in patients with cerebral hemorrhage,and a risk prediction model was established and a nomogram was drawn.A total of 110 patients with cerebral hemorrhage hospitalized in the same hospital from December 2022 to March 2023 were selected as the validation group,and the Hosmer-Lemeshow test and ROC curve were used to verify the model.Results In this study,four risk factors of hospital stay,Koubmwater swallowing test score,nutrition and diuretics were finally included to construct a risk prediction model,and the area under the ROC curve of the modeling group was 0.918,the 95%CI was 0.848 to 0.963,the optimal cut-off value was 0.7225,the sensitivity was 0.885,and the specificity was 0.837.External verification results showed a sensitivity of 0.926 and specificity of 0.611.Conclusions The risk prediction model constructed in this study has good effect and can provide reference for clinical assessment of whether patients with cerebral hemorrhage have the risk of constipation.

关 键 词：脑出血 便秘 预测模型 

分 类 号：R473.74[医药卫生—护理学]