宫颈癌患者术后尿潴留风险预测模型的构建及验证  

Construction and validation of risk prediction model for postoperative urinary retention in patients with cervical cancer

作　　者：杜晓冰 王启[1] 李亚南[2] 李博雅 马征泽 王菲[4] DU Xiaobing;WANG Qi;LI Yanan;LI Boya;MA Zhengze;WANG Fei(Day Surgery Ward,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Department of Nursing,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Department of Endocrinology and Metabolism,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Department of Gynaecology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院日间手术中心病房,郑州450052 [2]郑州大学第一附属医院护理部,郑州450052 [3]郑州大学第一附属医院内分泌与代谢科,郑州450052 [4]郑州大学第一附属医院妇科,郑州450052

出　　处：《郑州大学学报（医学版）》2024年第4期548-552,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省科技攻关项目(232102310119);河南省医学科技攻关省部共建重点项目(SBGJ202302079);郑州大学第一附属医院护理科研专项基金项目(HLKY2023012)。

摘　　要：目的:了解宫颈癌患者术后尿潴留的影响因素,构建风险预测模型。方法:收集2020年2月至2023年7月某三甲医院收治的宫颈癌手术患者1968例,随机分为训练集(1320例)和验证集(648例)。采用Logistic回归分析宫颈癌术后尿潴留的影响因素,根据结果构建风险预测模型并绘制列线图。采用ROC曲线、校准曲线和决策曲线分析(DCA)评估模型的预测价值。结果:年龄>60岁、广泛性子宫切除、术后发生尿路感染、术后留置尿管时间>14 d、术后使用止痛泵的患者,发生尿潴留的风险更高,OR(95%CI)分别为1.759(1.225~2.526)、5.557(3.386~9.121)、2.503(1.857~3.374)、8.909(6.224~12.754)、1.521(1.041~2.223)。训练集和验证集ROC曲线下面积(95%CI)分别为0.831(0.806~0.855)、0.822(0.785~0.859),校准曲线与理想曲线接近,DCA曲线远离基准线,预测结果与实际结局具有较好的一致性。结论:构建的宫颈癌术后尿潴留风险预测模型具有较好的预测价值。Aim:To explore the risk factors of postoperative urinary retention in patients with cervical cancer and build a risk prediction model.Methods:A retrospective study was conducted to collect 1968 patients with cervical cancer who were admitted to a class A tertiary hospital from February 2020 to July 2023.Patients were allocated into a training set(1320 cases)and a validation set(648 cases)randomly.Logistic regression was used to analyze the influencing factors of urinary retention after cervical cancer surgery.According to the results,a risk prediction model was constructed and a nomogram was drawn.ROC curves,calibration curves,and decision curve analysis(DCA)were used to evaluate the predictive value of the model.Results:The risk of urinary retention was higher in patients who was older than 60 years,who had undergone extensive hysterectomy,suffered from urinary tract infection after surgery,using urinary catheter for more than 14 days after surgery,and used pain relief pump after surgery,and the OR(95%CI)was 1.759(1.225-2.526),5.557(3.386-9.121),2.503(1.857-3.374),8.909(6.224-12.754),1.521(1.041-2.223),respectively.In training and validation sets,the area under the ROC curve(95%CI)was 0.831(0.806-0.855)and 0.822(0.785-0.859).The calibration curve was close to the ideal curve,while the DCA curve was far from the baseline,indicating good consistency between the predicted result and the actual outcome.Conclusion:The prediction model of urinary retention after cervical cancer surgery shows good predictive value.

关 键 词：宫颈癌 术后尿潴留 预测模型 

分 类 号：R473.71[医药卫生—护理学]