中华护理杂志 ›› 2022, Vol. 57 ›› Issue (18): 2217-2224.DOI: 10.3761/j.issn.0254-1769.2022.18.007
蒋伟红(), 金陈娣, 李帅妮, 杨山凤, 严川川, 诸纪华()
收稿日期:
2022-03-21
出版日期:
2022-09-20
发布日期:
2022-09-07
通讯作者:
诸纪华,E-mail: jihuazhu@zju.edu.cn作者简介:
蒋伟红,女,本科(硕士在读),护师,E-mail: 847610762@qq.com
基金资助:
JIANG Weihong(), JIN Chendi, LI Shuaini, YANG Shanfeng, YAN Chuanchuan, ZHU Jihua()
Received:
2022-03-21
Online:
2022-09-20
Published:
2022-09-07
摘要:
目的 构建先天性心脏病术后患儿中心静脉导管相关深静脉血栓(central venous catheter-associated deep venous thromboses,CADVT)风险预测模型,并验证该模型的预测效果。 方法 便利选取2021年1月—11月在浙江省某三级甲等儿童专科医院心脏外科监护室住院的234例患儿作为建模组,根据是否发生CADVT,将其分为CADVT组(53例)和非CADVT组(181例)。采用Logistic回归分析建立风险预测模型,采用Hosmer-Lemeshow检验判断模型的拟合优度,采用受试者操作特征曲线(receiver operator characteristic curve,ROC)检测模型的预测效果,并绘制列线图。选取2021年12月—2022年2月同一所医院收治的60例先天性心脏病术后患儿作为验证组,采用Hosmer-Lemeshow检验和ROC曲线对模型进行外部验证。 结果 先天性心脏病术后患儿CADVT发生率为22.65%。CVC留置时长(OR=1.172)、D-二聚体浓度(OR=1.169)、纤维蛋白原浓度(OR=3.888)、镇静天数(OR=1.538)、使用血管收缩药(OR=3.554)和儿科危重病例评分(OR=3.308)是其风险因素(P<0.05)。Hosmer-Lemeshow检验结果显示, χ2=4.456,P=0.814,ROC曲线下面积为0.957(95%CI:0.930~0.984),最佳临界值为0.813,灵敏度为0.962,特异度为0.851。外部验证结果显示,该模型的灵敏度为0.857,特异度为0.870,正确率为86.67%。 结论 该风险预测模型的预测效果良好,可为临床评估先天性心脏病术后患儿CADVT发生风险提供参考。
蒋伟红, 金陈娣, 李帅妮, 杨山凤, 严川川, 诸纪华. 先天性心脏病术后患儿中心静脉导管相关深静脉血栓风险预测模型的构建及验证[J]. 中华护理杂志, 2022, 57(18): 2217-2224.
JIANG Weihong, JIN Chendi, LI Shuaini, YANG Shanfeng, YAN Chuanchuan, ZHU Jihua. Construction and validation of a risk prediction model for central venous catheter-associated deep venous thromboses in children with congenital heart disease after surgery[J]. Chinese Journal of Nursing, 2022, 57(18): 2217-2224.
表1 先天性心脏病术后患儿中心静脉导管相关深静脉血栓发生风险的单因素分析
Table 1 The result of single factor analysis of central venous catheter-associated deep venous thromboses in children with congenital heart disease after surgery
表2 先天性心脏病术后患儿中心静脉导管相关深静脉血栓发生风险的Logistic回归分析
Table 2 Logistic regression analysis of central venous catheter-associated deep venous thrombosis in children with congenital heart disease after surgery
图1 先天性心脏病术后患儿中心静脉导管相关深静脉血栓风险预测列线图
Figure 1 A nomogram model for predicting central venous catheter-associated deep venous thrombosis in children with congenital heart disease after surgery
图2 建模组中心静脉导管相关深静脉血栓风险预测模型的受试者操作特征曲线
Figure 2 Receiver operating characteristic curve of the risk prediction model for central venous catheter-associa-ted deep venous thrombosis in the modeling group
图3 验证组中心静脉导管相关深静脉血栓风险预测模型的受试者操作特征曲线
Figure 3 Receiver operating characteristic curve of the risk prediction model for central venous catheter-asso-ciated deep venous thrombosis in the validation group
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