毒蛇咬伤致皮肤坏死性感染的危险因素及预测模型研究  

Study on risk factors and prediction model of skin necrotic infection caused by venomous snake bites

作　　者：郝嘉宁 王宇宏[1] 王文博 戴秋婷 朱明月 李伦超 赵晓东[1] 刘双庆[1] HAO Jianing;WANG Yuhong;WANG Wenbo;DAI Qiuting;ZHU Mingyue;LI Lunchao;ZHAO Xiaodong;LIU Shuangqing(Department of Emergency,the 4th Medical Center of General Hospital of PLA,Beijing,100037,China;Tianjin Rehabilitation Center of Joint Logistic Support Force;Department of Cardiology,the Second Clinical Affiliated Hospital of Three Gorges University)

机构地区：[1]解放军总医院第四医学中心急诊医学科,北京100037 [2]联勤保障部队天津康复疗养中心内分泌科 [3]三峡大学第二临床附属医院心内科

出　　处：《临床急诊杂志》2024年第3期110-114,共5页Journal of Clinical Emergency

摘　　要：目的:分析毒蛇咬伤致皮肤坏死性感染的危险因素,并构建预测模型。方法:回顾性分析99例毒蛇咬伤患者的临床资料,确定是否发生皮肤坏死性感染为结局,采用单因素及多因素logistics回归分析构建预测模型并予以验证。结果:蛇伤严重度评分、血糖及D-二聚体水平为毒蛇咬伤致皮肤坏死性感染的危险因素(均P<0.05)。利用上述危险因素构建列线图预测模型,预测发生皮肤坏死性感染的曲线下面积分别为0.92;预测模型的校准曲线在两组中均表现出较好的一致性。结论:蛇伤严重度评分、血糖及D-二聚体水平是毒蛇咬伤后发生皮肤坏死性感染的危险因素,该模型可为临床决策提供参考。Objective:To analyze the risk factors of skin necrotizing infections caused by venomous snake bites and construct a prediction model.Methods:Clinical data of 99 venomous snake bite patients were retrospectively analyzed to determine whether skin necrotizing infection occurred as an outcome,and predictive model was constructed and validated using unifactorial and multifactorial logistic regression analysis.Results:Snakebite severity score,blood glucose and D-dimer level were the risk factors of skin necrotizing infections caused by venomous snake bites(all P<0.05).The area under the curve for predicting the occurrence of skin necrotizing infections was 0.92 using the above risk factors to construct a column-line graph prediction model;the calibration curves of the prediction model showed good consistency in both groups.Conclusion:Snakebite severity score,blood glucose and D-dimer levels are risk factors for the occurrence of skin necrotizing infection after venomous snake bites,and the model can provide a reference for clinical decision-making.

关 键 词：毒蛇咬伤 坏死性感染 危险因素 预测模型 

分 类 号：R646[医药卫生—外科学]