| 李婷婷,李晓琴,王祝平.上消化道肿瘤患者术后早期肠内营养喂养不耐受风险预测模型的构建[J].上海护理,2024,24(2): |
| 上消化道肿瘤患者术后早期肠内营养喂养不耐受风险预测模型的构建 |
| Construction of a risk prediction model for early postoperative enteral feeding intolerance in patients with upper gastrointestinal tumors |
| DOI： |
| 中文关键词: 上消化道肿瘤 肠内营养 喂养不耐受 预测模型 |
| 英文关键词:upper gastrointestinal tumor Enteral nutrition Feeding intolerance Predictive models |
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| 中文摘要: |
| 目的：分析上消化道肿瘤患者术后发生早期肠内营养喂养不耐受的危险因素,建立风险预测模型,有效识别高危患者。方法：回顾性分析2021年5月～2022年12月收治于我院普外科的210例上消化道肿瘤患者病例资料,所有患者术后均行肠内营养支持治疗。根据是否发生术后早期肠内营养喂养不耐受,分为耐受组(n=121)与不耐受组(n=89),比较两组患者间的一般资料差异,运用Logistic回归分析上消化道肿瘤患者术后早期肠内营养喂养不耐受的危险因素,构建风险预测模型,ROC曲线下面积评价对模型的校准度、区分度。结果： logistic回归分析结果显示,低蛋白血症、高血糖、胃肠内补钾、术后疼痛评分≥4分、术后3天内下床活动为上消化道肿瘤患者术后早期肠内营养喂养不耐受的独立危险因素,构建预测模型后,经 Hosmer-Lemeshow 检验,χ2=6.523,P=0.367,ROC 曲线下面积为0.916,P< 0.001,灵敏度为0.857,特异度为0.832。结论：本研究构建的预警模型能准确预测上消化道肿瘤患者术后早期肠内营养喂养不耐受的发生,帮助临床医护人员识别肠内营养喂养不耐受高危人群,为早期采取干预护理措施提供参考依据。 |
| 英文摘要: |
| Objective To analyze the risk factors for early enteral feeding intolerance in patients with upper gastrointestinal tumors, establish a risk prediction model, and effectively identify high-risk patients. Methods A retrospective analysis was performed for the case data of 210 patients with upper gastrointestinal tumors admitted to the Department of Surgery of our hospital from May 2021~December 2022, and all patients underwent enteral nutrition support therapy after surgery. According to whether there was early postoperative enteral feeding intolerance, it was divided into tolerance group (n=121) and intolerance group (n=89), compared the general data differences between the two groups, and logistic regression was used to analyze the risk factors for early enteral feeding intolerance in patients with upper gastrointestinal tumors after surgery, and a risk prediction model was constructed, and the area under the ROC curve was evaluated to evaluate the calibration degree and differentiation of the model. Results The results of logistic regression analysis showed that hypoproteinemia, hyperglycemia, gastrointestinal potassium supplementation, postoperative pain score ≥4 points, and getting out of bed within 3 days after surgery were independent risk factors for early enteral feeding intolerance in patients with upper gastrointestinal tumors<. Conclusion The early warning model constructed in this study can accurately predict the occurrence of enteral feeding intolerance in patients with upper gastrointestinal tumors in the early postoperative period, help clinical medical staff identify high-risk groups of enteral feeding intolerance, and provide a reference for early intervention and nursing measures. |
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