肠造口周围潮湿相关性皮肤损伤预测模型的构建与应用  

作　　者：吴金晶[1] 李红[1] 

机构地区：[1]浙江省丽水市中心医院,323000

出　　处：《浙江临床医学》2024年第8期1248-1250,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2022KY1427)。

摘　　要：目的探讨肠造口周围潮湿相关性皮肤损伤(PMASD)预测模型的构建与应用效果。方法回顾性分析2022年1月至2023年6月369例行肠造口手术患者的临床资料,并将其为建模组(268例)和验证组(101例)。根据患者是否发生PMASD分为并发症组(91例)与非并发症组(177例),基于单因素分析、Lasso变量精简剔除后采用多因素Logistic回归分析预测模型并通过Hosmer-Lemeshow检验预测模型拟合度,同时在验证组中进行模型外部验证。结果建模组所有变量的组间比较,差异均有统计学意义(P<0.05)。经过方差分析精简剔除后采用Logistic回归分析构建的预测模型Hosmer-Lemeshow检验P=0.763,预测模型准确率为90.51%。预测模型外部验证总准确率为77.23%,Hosmer-Lemeshow检验P=0.516,ROC曲线下面积为0.858(P<0.01)。结论PMASD预测模型可以帮助医护人员及时发现和处理皮肤损伤,减少感染和其他并发症的发生率,具有重要的临床指导意义。Objective To develop and assess a predictive model for moisture-related skin damage(PMASD)near intestinal stomas.Methods The clinical data of 369 patients undergoing enterostomy from January 2022 to June 2023 were retrospectively analyzed.Participants were categorized into a model development group(268 cases)and a validation group(101 cases).The development group was further divided into those with PMASD(91 cases)and those without(177 cases).Univariate analysis and Lasso variable selection informed the creation of a Logistic regression predictive model.The model's fit was assessed using the Hosmer-Lemeshow test and externally validated with the validation group.Results Between-group comparisons of all variables in the modelling group showed statistically significant differences(P<0.05).The predictive model constructed by Logistic regression analysis after ANOVA streamlining and elimination Hosmer-Lemeshow test P=0.763,the correct rate of the predictive model was 90.51%.The total correct rate of external validation of the prediction model was 77.23%,with a Hosmer-Lemeshow test P=0.516 and an area under the ROC curve of 0.858(P<0.01).Conclusion The developed predictive model for PMASD around colostomy sites offers significant clinical utility.It enables healthcare professionals to promptly identify and manage skin damage,thereby reducing the risk of infections and other complications.

关 键 词：肠造口术 造口周围潮湿相关性皮肤损伤 预测模型 护理 

分 类 号：R473.6[医药卫生—护理学]