摘要： 目的 探讨糖尿病患者术中发生皮肤压力性损伤的危险因素，建立术中皮肤压力性损伤发生风险的列线图预测模型。方法 采用回顾性调查分析，选取于我院接受手术且符合纳入标准的820例糖尿病患者为研究对象。收集患者临床资料，采用logistic回归分析发生术中皮肤压力性损伤的独立危险因素，并建立糖尿病患者术中皮肤压力性损伤发生风险的列线图预测模型。采用校正曲线和受试者操作特征（ROC）曲线评估列线图预测模型的准确度和区分度。结果 糖尿病患者术中皮肤压力性损伤的发生率为12.19%。多因素logistic回归分析显示，年龄、手术体位、手术时间、空腹血糖、低蛋白血症为糖尿病患者发生术中皮肤压力性损伤的独立危险因素（P < 0.05）。基于上述危险因素构建糖尿病患者术中皮肤压力性损伤发生风险的列线图预测模型，校正曲线提示模型准确度良好，ROC曲线下面积为0.842，提示模型具有良好区分度。结论 本研究通过分析糖尿病患者术中皮肤压力性损伤的危险因素，依此构建术中皮肤压力性损伤风险列线图预测模型，模型具有良好的准确度和区分度，可有效预测糖尿病患者术中皮肤压力性损伤发生风险，帮助医护人员采取针对性预防措施，有效降低糖尿病患者术中皮肤压力性损伤发生率。

糖尿病患者术中皮肤压力性损伤风险列线图预测模型的构建

付佳, 田甜

中国医科大学附属盛京医院第一手术室, 沈阳 110004

收稿日期:2021-07-26出版日期:2021-11-30发布日期:2021-11-04
通讯作者:付佳E-mail:fu_jia_123@outlook.com
作者简介:付佳(1985-),女,护师,本科.
基金资助:辽宁省自然科学基金（ZF2019019）


关键词: 糖尿病, 压力性损伤, 列线图, 预测模型, 手术
Abstract: Objective To explore the risk factor of skin pressure injury in diabetic patients during operation and establish a nomogram prediction model. Methods A total of 820 diabetic patients who underwent operation and met the inclusion criteria were selected for the study via retrospective investigation analysis. Based on the clinical data of the subjects, logistic regression was performed to analyze the independent risk factors of pressure injury during operation and a nomogram prediction model was established. The calibration and receiver operating characteristic curves were used to evaluate the accuracy and discrimination of the nomogram model. Results The incidence of skin pressure injury during the operation was 12.19%. Multivariate logistic regression analysis showed that age, operation position, operating time, fasting blood glucose levels, and hypoproteinemia were independent risk factors for skin pressure injury in diabetic patients during operation (P < 0.05). Based on these independent risk factors, a nomogram prediction model was successfully constructed. The calibration curve indicated that the model possessed good accuracy. The area under the curve was 0.842, indicating that the model possessed good discrimination. Conclusion Our study constructed a nomogram prediction model based on the independent risk factors for intraoperative skin pressure injury in diabetic patients. The prediction model had good accuracy and discrimination and could effectively predict the occurrence of skin pressure injury and help medical staff take targeted preventive measures to prevent skin pressure injury.
Key words: diabetes, pressure injury, nomogram, predictive model, operation
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