Abstract:

Objective To analyze the influencing factors of hypoglycemia in patients undergoing colonoscopy and to construct a risk prediction model and evaluate the model. Methods A total of 528 patients who underwent colonoscopy were selected by the convenience sampling method from the gastroenterology department of a tertiary A hospital in Qingdao from March 2022 to August 2022. Their general information，laboratory indicators and operation-related data were collected. Multivariate Logistic regression was used to analyze the risk factors of hypoglycemia in patients with colonoscopy for risk prediction model construction，and its prediction effect was evaluated by drawing a nomogram. Results Hypoglycemia occurred in 66 of 528 patients，with an incidence of 12.50%. The risk factors finally in the risk prediction model in Logistic regression were drinking history，long fasting time after operation，polyethylene glycol（PEG）-electrolyte solutions>3 L，low quality of bowel preparation. The model passed Hosmer-Lemeshow goodness of fit test χ²=10.158（P=0.200）. The area under the ROC curve was 0.829，while the cut-off was 0.575，with sensitivity of 92.90% and specificity of 64.60%. Conclusion Patients undergoing colonoscopy have a higher risk of hypoglycemia. Patients with a history of drinking，longer fasting after surgery，more than 3 L of PEG-electrolyte solutions，and low quality of bowel preparation were more likely to develop hypoglycemia. The established risk prediction model has a good effect，providing the reference for screening high-risk group of hypoglycemia and taking preventive and protective measures.

Key words: Colonoscopy, Bowel Preparation, Hypoglycemia, Root Cause Analysis, Risk Prediction Model, Nursing Care

摘要：

目的 分析结肠镜检查患者发生低血糖的影响因素，建立风险预测模型，并评价其预测效果。方法 采用便利抽样法，选取2022年3月—8月在青岛市某三级甲等综合医院消化内科行结肠镜检查的528例患者作为调查对象，回顾性收集患者的一般资料、实验室检查指标和结肠镜检查相关资料，通过Logistic回归构建结肠镜检查患者低血糖发生风险预测模型，绘制列线图并评价其预测效果。结果 在528例患者中有66例发生低血糖，发生率为12.50%。Logistic回归分析结果显示，有无饮酒史、检查后禁食时长、复方聚乙二醇电解质散溶液用量是否>3 L、肠道准备是否合格是结肠镜检查患者发生低血糖的影响因素（P<0.05），该模型Hosmer-Lemeshow拟合优度检验结果为χ²=10.158（P=0.200），表明模型拟合度较好，受试者操作特征曲线下面积为0.829，最佳临界值为0.575，模型灵敏度为92.90%，特异度为64.60%。结论 结肠镜检查患者低血糖发生风险较高，有饮酒史、检查后禁食时长较长、复方聚乙二醇电解质散溶液用量>3 L、肠道准备不合格的患者更易发生低血糖。该研究构建的风险预测模型预测效果良好，可为医护人员预测结肠镜检查患者低血糖的发生风险提供参考。

关键词: 结肠镜检查, 肠道准备, 低血糖, 影响因素分析, 风险预测模型, 护理