主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
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中国护理管理 ›› 2025, Vol. 25 ›› Issue (8): 1229-1234.doi: 10.3969/j.issn.1672-1756.2025.08.020

• 护理安全 • 上一篇    下一篇

脊柱后路手术患者术中获得性压力性损伤风险预测模型的构建

张霞 吴莹 张梦丽 梁衡渝 李瑞杰 曾玉   

  1. 南昌大学第一附属医院手术室,330006 南昌市(张霞,吴莹,曾玉);南昌大学护理学院(张梦丽,梁衡渝,李瑞杰);西安交通大学第一附属医院神经内科(张霞)
  • 出版日期:2025-08-15 发布日期:2025-08-15
  • 通讯作者: 曾玉,硕士,主任护师,总护士长,E-mail:865494812@qq.com
  • 作者简介:张霞,硕士
  • 基金资助:
    南昌大学第一附属医院临床研究培育项目(YFYLCYJPY202418);国家卫生健康委医院管理研究所围术期护理质控管理专项研究项目(NIHAHL2515)

Construction of a risk prediction model for Intraoperative Acquired Pressure Injuries in patients undergoing posterior spinal surgery

ZHANG Xia, WU Ying, ZHANG Mengli, LIANG Hengyu, LI Ruijie, ZENG Yu   

  1. Operating Room, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China; Neurology Department, The First Affiliated Hospital of Xi'an Jiao Tong University
  • Online:2025-08-15 Published:2025-08-15
  • Contact: E-mail:865494812@qq.com

摘要: 目的:分析脊柱后路手术患者发生术中获得性压力性损伤(Intraoperative Acquired Pressure Injury,IAPI)的影响因素并构建风险预测模型,以期为该类手术患者提供压力性损伤的筛查工具。方法:选取2022年11月至2023年3月江西省南昌市某三级甲等医院骨科行脊柱后路手术的435名患者为研究对象,收集其临床资料,通过单因素分析和Logistic回归分析筛选危险因素,构建风险预测模型,并绘制列线图。结果:共有66名患者发生IAPI,发生率为15.17%。Logistic回归分析显示,年龄(OR=1.052)、糖尿病(OR=3.310)、BMI(OR=2.977)、脊髓损伤(OR=3.106)、手术时长(OR=1.027)、血清白蛋白(OR=0.874)是脊柱后路手术患者发生IAPI的影响因素(P<0.05)。列线图模型ROC曲线下面积为0.864(95%CI:0.820~0.908),表明模型具有较好的区分度;拟合优度(Hosmer-Lemeshow)检验结果为χ2=3.004,P=0.934,模型具有较好的拟合程度;校准曲线图显示发生IAPI的预测概率与实际的观测概率之间存在良好的校准度。结论:本研究构建的脊柱后路手术患者IAPI风险预测模型的预测效能良好,具有一定的临床应用价值。

关键词: 脊柱后路手术;术中获得性压力性损伤;预测模型

Abstract: Objective: To analyze the influencing factors of Intraoperative Acquired Pressure Injuries (IAPI) in patients undergoing posterior spinal surgery and construct a risk prediction model, aiming to provide a screening tool for such patients. Methods: A total of 435 patients who underwent posterior spinal surgery from November 2022 to March 2023 at a tertiary hospital in Nanchang were enrolled. Their clinical data were collected. Univariate and Logistic regression analysis were used to identify risk factors and construct a risk prediction model, followed by the creation of a nomogram. Results: IAPI occurred in 66 patients, with an incidence rate of 15.17%. Logistic regression analysis showed that age (OR=1.052), diabetes (OR=3.310), BMI (OR=2.977), spinal cord injury (OR=3.106), surgical duration (OR=1.027), and serum albumin (OR=0.874) were influencing factors for IAPI (P<0.05). The nomogram model had an AUC of 0.864 (95% CI: 0.820, 0.908), indicating good discrimination. The Hosmer-Lemeshow test showed χ2=3.004 and P=0.934, suggesting good model fit. The calibration curve demonstrated good agreement between predicted and observed probabilities of IAPI. Conclusion: The constructed risk prediction model for IAPI in patients undergoing posterior spinal surgery shows good predictive performance and holds clinical application value.

Key words: posterior spinal surgery; Intraoperative Acquired Pressure Injury; prediction model

中图分类号:  R47;R197