列线图用于极/超早产儿坏死性小肠结肠炎预测的研究

摘要/Abstract

摘要： 目的对于极/超早产儿坏死性小肠结肠炎（Necrotizing Enterocolitis,NEC）的危险因素进行深入探讨,并致力于构建一个早期预测模型,以协助临床医生更为迅速地对NEC风险进行评估。方法回顾性选取2021年1月—2023年12月连云港市妇幼保健院新生儿重症监护室收治的出生胎龄<32周、生后24 h内入院的181例极/超早产儿作为本次研究对象,根据临床表现、实验室检查以及腹部X线片,将结果异常的患儿纳入NEC组,将结果正常的纳入对照组。收集母亲孕产史、新生儿出生史、生后第1次血常规、血气分析、母乳喂养等临床资料。采用单因素分析、多因素逻辑回归筛选出可能的预测变量,建立早期NEC预测模型。采用一致性指数（C指数）评价模型的区分度,采用Bootstrap 1 000次重抽样的校准来测量Nomogram的准确度。结果共纳入181例极/超早产儿,其中NEC 34例（18.7%）,无NEC 147例（81.2%）。男性（OR=3.223,95%CI：1.055~9.840,P=0.040）、胎龄（OR=0.433,95%CI：0.255~0.735,P=0.002）、母乳喂养（OR=0.094,95%CI：0.024~0.368,P<0.001）是NEC的独立影响因素,列线图在预测NEC的发生方面有良好的区分度,一致性指数（C指数）为0.815（95%CI：0.738~0.891）。Bootstrap重抽样1 000次显示曲线拟合良好（校准曲线围绕斜率1上下摆动,平均绝对错误率0.03,n=181）。结论通过母亲孕产史、新生儿出生史及早期临床资料可建立极/超早产儿NEC早期预测模型,有助于医生早期临床决断。

关键词: 坏死性小肠结肠炎, 极/超早产儿, 危险因素, 预测模型

中图分类号:

R722.1

付马, 金瑞, 仰守红. 列线图用于极/超早产儿坏死性小肠结肠炎预测的研究[J]. 中华养生保健, 2025, 43(7): 72-76.

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