| 杨琳,段颖,邓小东,等.预测 ICU机械通气病人发生腹泻风险的列线图模型建立[J].安徽医药,2025,29(4):733-737. |
| 预测 ICU机械通气病人发生腹泻风险的列线图模型建立 |
| Establishment of a nomograph model for the prediction of diarrhea risk in ICU patients with mechanical ventilation |
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| DOI：10.3969/j.issn.1009-6469.2025.04.020 |
| 中文关键词: 呼吸，人工 腹泻 重症监护室 列线图模型 肠内营养 |
| 英文关键词: Respiration,artificial Diarrhea Intensive care unit Nomograph model Enteral nutrition |
| 基金项目:四川省医学科研课题项目( S20041) |
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| 中文摘要: |
| 目的构建重症监护室( ICU)机械通气病人发生腹泻风险的列线图预测模型，为临床护理干预提供理论依据。方法选取 2019年 4月至 2022年 9月入住攀枝花市中心医院 ICU且行机械通气的 184例病人为研究对象，根据是否发生腹泻将病人分为腹泻组 52例和非腹泻组 132例。采用单因素及多因素 logistic回归分析 ICU机械通气病人发生腹泻的影响因素；采用 R4.0.2软件包构建 ICU机械通气病人发生腹泻的风险预测列线图模型，采用 Bootstrap法验证列线图模型；采用受试者操作特征曲线( ROC曲线)曲线下面积( AUC)检验列线图模型对 ICU机械通气病人发生腹泻的预测效能。结果腹泻组较非腹泻组病人年龄 ≥60岁( 88.46%比 40.91%)、 ICU入住时间 ≥7 d(82.69%比 38.64%)、机械通气时间 ≥3 d(69.23%比 43.94%)、肠内营养(EN)前禁食( 78.85%比 31.82%)、 EN制剂日用量 ≥600 mL(84.62%比 40.15%)的占比更高( P<0.05)。年龄、 ICU入住时间、机械通气时间、 EN前禁食、 EN制剂日用量均是影响 ICU机械通气病人发生腹泻的独立危险因素( P<0.05)。构建的列线图模型校正曲线趋近于理想曲线。拟合优度检验 χ2=2.41，P=0.660。ROC的 AUC 95%CI为 0.85(0.79，0.90)。结论基于年龄、 ICU入住时间、机械通气时间、 EN前禁食、 EN制剂日用量建立的预测 ICU机械通气病人发生腹泻的列线图模型，可有效预测发生腹泻的高危病人。 |
| 英文摘要: |
| Objective To establish a nomograph prediction model for diarrhea risk of ICU patients with mechanical ventilation, andto provide a theoretical basis for clinical nursing intervention.Methods A total of 184 patients who were admitted to the ICU and re.ceived mechanical ventilation from April 2019 to September 2022 Panzhihua Central Hospital were selected as the study subjects.Patients were assigned into diarrhea group (n=52) and non-diarrhea group (n=132) according to whether they had diarrhea or not. Uni.variate and multivariate logistic regression were used to analyze the influencing factors of diarrhea in ICU patients with mechanicalventilation; R4.0.2 software package was used to construct a nomograph model for predicting the risk of diarrhea, Bootstrap methodused to validate the nomogram model. The area under the curve (AUC) from receiver operating characteristic curve (ROC curve) wasused to test the predictive efficacy of the nomogram model for diarrhea. Results The proportions of age ≥ 60 years (88.46% vs. 40.91%), ICU length of stay ≥ 7 d (82.69% vs. 38.64%), duration of mechanical ventilation ≥ 3 d (69.23% vs. 43.94%), fasting before enteral nutrition (EN) (78.85% vs. 31.82%), and daily dosage of EN ≥ 600 mL (84.62% vs. 40.15%) in the diarrhea group were obvi. ously higher than those in non-diarrhea group (P<0.05). Age, ICU length of stay, duration of mechanical ventilation, fasting beforeEN, and daily dosage of EN were all independent risk factors for diarrhea in ICU patients with mechanical ventilation (P<0.05). The calibration curve of the nomogram model was close to the ideal curve. Goodness of fit test χ2=2.41, P=0.660. AUC 95%CI from ROC was 0.85 (0.79,0.90).Conclusion The nomograph model, based on age, ICU length of stay, duration of mechanical ventilation, fast.ing before EN, and daily dosage of EN to predict diarrhea in ICU patients with mechanical ventilation, can effectively predict thehigh-risk population of diarrhea. |
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