| 罗丹,顾群,李红仙,汪馨婷.腹膜透析相关性腹膜炎早期预警评估表的构建与验证[J].上海护理,2024,24(7): |
| 腹膜透析相关性腹膜炎早期预警评估表的构建与验证 |
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| 投稿时间：2023-10-10 修订日期：2024-06-29 |
| DOI： |
| 中文关键词: 腹膜透析相关性腹膜炎 预警 评估 |
| 英文关键词: |
| 基金项目:上海市长宁区卫计委科研( 20194Y024 )；海军特色医学中心护理科研专项(20MN01) |
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| 中文摘要: |
| [目的] 建立并验证腹膜透析相关性腹膜炎早期预警评估表。[方法]采用回顾性研究方法,选取2010年1月—2019年12月期间在我院腹膜透析中心接受PD治疗的随访患者154名为研究对象。采用二元Logistic 回归分析确定独立危险因素,保存回归分析结果中预测概率值用于绘制ROC曲线,依据约登指数确定截断值并进行分组,根据各独立危险因素的回归系数构建PDAP早期预警评估表。[结果]二元Logistic回归分析确定导管出口皮肤情况、血红蛋白(Hb)、血清白蛋白(ALB)、降钙素原(PCT)为腹膜透析相关性腹膜炎发生的4个独立危险因素。将独立危险因素纳入ROC曲线,ROC曲线下面积(AUC)为0.997。根据约登指数确定Hb≤98.5mmol/L,导管出口皮肤评估≥3分,ALB≤33.9mmol/L,PCT＞0.1Ug/mL为预测PDAP的最佳截断值,建立PDAP早期预警评估表(PDAP-EWS)。依据评分的截断值将 154例病人进行风险分级,0～4分为低风险组,5～11分为高风险组,比较两组PDAP感染率差异具有统计学意义(χ2=133.610,P＜0.001)。[结论]构建的腹膜透析相关性腹膜炎早期预警评估表,收集资料简单,经检验具有良好的预测准确性和临床实用性,可帮助护士准确、快速的识别PDAP的发生,前置护理干预策略。 |
| 英文摘要: |
| [ Objective ] To establish and validate an early warning assessment form for peritoneal dialysis-associated peritonitis. [Methods ] A retrospective study was carried out in 154 PD patients who were treated in our peritoneal dialysis center . The independent risk factors were determined by binary Logistic regression analysis. The predicted probability values of the regression results were saved for drawing the ROC curve, and the cut-off values were determined according to the Youden Index and grouped, PDAP early warning evaluation table was constructed according to the regression coefficients of independent risk factors. [ Results ] Dual Logistic regression analysis identified catheter outlet skin, hemoglobin (Hb) , Alb (ALB) and Procalcitonin (PCT) as four independent risk factors for pd-related peritonitis. Independent risk factors were included in the ROC curve, and the area under the ROC curve (AUC) was 0.997. HB ≤98.5 mmol/l, catheter exit skin assessment ≥3 points, ALB ≤33.9 mmol/l, PCT ＞ 0.1 ug/mL were determined as the best cut-off values for predicting PDAP, and an early warning assessment form for PDAP (PDAP-EWS)was established. According to the cut-off value of the score, 154 patients were classified into low-risk group (0-4) and high-risk group (5-11) . The difference of infection rate of PDAP between the two groups was statistically significant (χ2 = 133.610, p < 0.001) . [ Conclusion ] The early warning evaluation form for peritoneal dialysis associated peritonitis is simple to collect data and has good prediction accuracy and clinical practicability, it can help nurses to identify the occurrence of PDAP accurately and quickly, and preposition nursing intervention strategy. |
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