腰椎术后康复护理效果风险预警模型构建  

Construction of Risk Early Warning Model for Rehabilitation Effect After Lumbar Spine Surgery

作　　者：王怡涵 徐静宜[2] 温艳[2] 徐莉 张自文 Wang Yihan;Xu Jingyi;Wen Yan(Luohe Medical College,Luohe,Henan,462000,China)

机构地区：[1]漯河医学高等专科学校,河南漯河462000 [2]漯河市中心医院,河南漯河462000 [3]辽宁医药职业学院,辽宁沈阳110101

出　　处：《黑龙江医学》2025年第7期858-861,共4页Heilongjiang Medical Journal

基　　金：河南省医学科技攻关计划项目(LHGJ20200892)。

摘　　要：目的:探讨腰椎术后康复护理效果,促进患者康复并降低其再入院率。方法:选取2021年1月—2022年5月样本医院收治的243例腰椎术后患者作为研究对象,按照7∶3随机将其分为训练集(n=168)和验证集(n=73)。根据术后6个月患者康复效果分为优良组和不良组,训练集中优良组140例、不良组28例,验证集中优良组60例、不良组13例。采用logistic回归分析筛选腰椎术后康复效果不佳的影响因素并构建风险预警模型,绘制受试者工作特征(ROC)曲线,采用曲线下面积(AUC)评价风险预警模型的预测效能。结果:术后6个月,采用电话及门诊形式随访,共有2例失访,Oswestry功能障碍指数(ODI)总分为(10.12±1.45)分,康复优良率为86.31%。logistic回归分析结果发现,体质量指数(BMI)、椎间盘突变等级、突出节段、糖尿病史、术后活动程度是腰椎术后康复不良的影响因素(OR=11.045、7.015、14.922、12.891、8.008,P<0.001)。根据列线图风险预警模型绘制ROC曲线,训练集和验证集的AUC分别为0.902、0.896。结论:基于BMI、椎间盘突变等级、术后活动程度、突出节段、糖尿病史构建的列线图可用于腰椎术后康复效果预测,为腰椎术后患者康复提供依据。Objective:To explore the rehabilitation effect of lumbar spine surgery,so as to improve the rehabilitation effect.Methods:A total of 243 postoperative lumbar spine patients from January 2021 to May 2022 were selected as the study subjects.The population was randomly divided into the training set(n=168)and the validation set(n=73)in accordance with 7∶3,and was divided into the poor group and the good group according to the 6-month postoperative rehabilitation effect.There were 140 good group and 28 poor group in the training concentration,and 60 good group and 13 poor group in the verification concentration.Logistic regression analysis was used to screen the influencing factors of poor postoperative rehabilitation of lumbar spine,and the risk early warning model was constructed.Receiver operating characteristic(ROC)curve and area under the curve(AUC)were drawn to evaluate the prediction efficiency of the risk early warning model.Results:During the follow-up 6 months after operation,a total of 2 cases were lost to follow-up,and the recovery rate was 86.31%.Logistic regression equation showed that BMI,intervertebral disc mutation grade,herniated segment,history of diabetes,and postoperative activity level were high-risk factors for poor rehabilitation after lumbar spine surgery(OR=11.045,7.015,14.922,12.891,8.008;P<0.05).The AUCs for the training and validation sets were 0.902 and 0.896,respectively.Conclusion:The nomogram constructed based on BMI,intervertebral disc mutation grade,postoperative activity degree,herniated segment,and history of diabetes can be used to predict the rehabilitation effect of lumbar spine surgery,and help clinicians to formulate rehabilitation methods early.

关 键 词：腰椎间盘突出症 经皮椎间孔镜下腰椎间盘切除术 康复 护理 

分 类 号：R49[医药卫生—康复医学]