术后患者低氧血症风险预测模型的范围综述  

A scoping review of hypoxemia risk prediction models for postoperative patients

作　　者：王祥源 葛洪霞 时丽莹 邵珂 王文梓 李朔韬 王伟 Wang Xiangyuan;Ge Hongxia;Shi Liying;Shao Ke;Wang Wenzi;Li Shutao;Wang Wei(School of Nursing,Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学护理学院,济南250014

出　　处：《中华现代护理杂志》2025年第3期398-404,共7页Chinese Journal of Modern Nursing

摘　　要：目的对术后患者低氧血症风险预测模型进行归纳总结,为临床护理实践及未来术后患者低氧血症风险预测模型的研究提供借鉴。方法计算机系统检索中国知网、中国生物医学文献数据库、万方数据库、PubMed、Web of Science核心集、Cochrane Library、Embase、CINAHL数据库,检索时限均为建库至2024年1月31日。由2名研究者独立筛选文献并对纳入文献进行数据提取、整合分析和偏倚风险评价。结果共纳入17篇文献,涉及17个模型。研究人群以成年人为主,结局事件发生率为2.40%~49.30%。建模方法包括Logistic回归、决策树算法;模型展示形式分为风险评分公式、列线图、决策树形图以及网页计算器4类;出现频次最高的5项预测因子为体重指数、年龄、合并症、术中体外循环时间和术前白细胞计数;16个模型报告了受试者工作特征曲线下面积,为0.667~0.916;17个研究均存在一定的偏倚风险。结论现有研究构建的术后患者低氧血症风险预测模型的性能较好,但整体偏倚风险水平较高;未来可参照预测模型偏倚风险评估清单规范模型构建过程,建立偏倚风险低、临床实用性强的模型。Objective To summarize the risk prediction models for postoperative hypoxemia and provide a reference for clinical nursing practice and future research on hypoxemia risk prediction models for postoperative patients.Methods A systematic literature search was conducted in CNKI,CBM,Wanfang,PubMed,Web of Science Core Collection,Cochrane Library,Embase,and CINAHL databases,covering publications up to January 31,2024.Two researchers independently screened the literature,extracted data,performed integrative analysis,and evaluated the risk of bias in the included studies.Results Seventeen studies were included,involving 17 different prediction models.The study populations were primarily adult patients,with hypoxemia incidence rates ranging from 2.40%to 49.30%.Modeling methods included Logistic regression and decision tree algorithms.The presentation formats of the models included risk scoring formulas,nomograms,decision tree diagrams,and web calculators.The five most frequently identified predictive factors were body mass index,age,comorbidities,duration of intraoperative cardiopulmonary bypass,and preoperative white blood cell count.Sixteen models reported the area under the receiver operating characteristic curve ranging from 0.667 to 0.916.All 17 studies exhibited varying degrees of bias risk.Conclusions Existing risk prediction models for postoperative hypoxemia demonstrate good performance;however,the bias risk level of all studies was high.Future research should standardize the model development process according to bias risk assessment checklists to establish models with low bias risk and strong clinical applicability.

关 键 词：综述 术后低氧血症 风险评估 预测模型 

分 类 号：TP3[自动化与计算机技术—计算机科学与技术]