摘要
目的:分析新生儿窒息的相关危险因素,并构建Nomogram预测模型。方法:回顾性分析2020年5月—2022年4月于医院分娩的230例新生儿临床资料,根据是否发生窒息分为观察组(n=11)和对照组(n=219)。对两组的临床资料进行统计分析,通过受试者工作特征(ROC)曲线分析有统计学意义的连续性变量;采用多元Logistic回归模型分析新生儿窒息的独立危险因素;R软件构建预测新生儿窒息的Nomogram预测模型;校正曲线对Nomogram预测模型进行内部验证;决策曲线评估模型的临床净收益。结果:观察组产妇年龄高于对照组;早产儿比例、胎位异常比例、产妇异常妊娠史比例、胎膜早破比例、产妇先兆流产史比例、初产比例和产妇妊娠期高血压比例高于对照组(均P<0.05)。产妇年龄曲线下面积(AUC)是0.829,最佳截断值是35岁。产妇年龄(≥35岁)、早产儿、胎位异常、初产和产妇妊娠期高血压是新生儿窒息的独立危险因素(P<0.05)。结论:本研究基于产妇年龄、早产儿、胎位异常、初产和产妇妊娠期高血压构建了新生儿窒息危险因素的Nomogram预测模型,有助于医护人员认识窒息相关高危因素,制定个性化护理对策,为临床防治提供参考。
Objective:To analyze the risk factors related to neonatal asphyxia and construct a Nomogram prediction model.Methods:The clinical data of 230 newborns delivered in the hospital from May 2020 to April 2022 were retrospectively analyzed and divided into an observation group(n=11)and a control group(n=219)according to whether asphyxia occurred.The clinical data of the two groups were statistically analyzed,and the receiver operating characteristic(ROC)curve was used to analyze the statistically significant continuous variables.The multivariate logistic regression model was used to analyze the independent risk factors of neonatal asphyxia.The R software was used to construct a Nomogram prediction model for predicting neonatal asphyxia.The calibration curve was used to verify the Nomogram prediction model internally.The decision curve was used to evaluate the clinical net benefit of the model.Results:The maternal age in the observation group was higher than that in the control group.The proportion of premature infants,abnormal fetal position,abnormal pregnancy history,premature rupture of membranes,threatened abortion history,primiparity,and gestational hypertension in the observation group were higher than those in the control group(all P<0.05).The area under the curve(AUC)of maternal age was 0.829,and the optimal cutoff value was 35 years old.Maternal age(≥35 years old),premature infants,abnormal fetal position,primiparity,and gestational hypertension were independent risk factors for neonatal asphyxia(P<0.05).Conclusions:This study constructed a Nomogram prediction model for neonatal asphyxia risk factors based on maternal age,premature infants,abnormal fetal position,primiparity,and gestational hypertension,which is helpful for medical staff to recognize high-risk factors related to asphyxia,formulate personalized nursing countermeasures,and provide some reference for clinical prevention and treatment.
作者
吴艳雪
梁柳瑜
郑丽南
WU Yanxue;LIANG Liuyu;ZHENG Linan(Children′s Hospital of Putian,Fujian 351100 China)
出处
《全科护理》
2024年第19期3578-3582,共5页
Chinese General Practice Nursing
