浏览全部资源
扫码关注微信
基于DynNom动态评分构建心脏搭桥术后压力性损伤的风险预测模型
Construction of a risk prediction model for pressure injuries after coronary artery bypass grafting based on DynNom dynamic score
- 局解手术学杂志 2026年35卷第2期 页码：93-97
- 作者机构：
南京医科大学第一附属医院心脏大血管外科监护，江苏 南京 210029
- 作者简介：
耿丹丹，E-mail：gengdandan1988@126.com
- 基金信息：国家自然科学基金(82202402);中国社会福利基金会护爱基金(HLCXKT-20230180)
DOI：10.11659/jjssx.08E025110
中图分类号： R473.6收稿：2025-08-28，
纸质出版：2026-02-25
- 稿件说明：
移动端阅览
朱鑫玥,徐天宁,司林杰等.基于DynNom动态评分构建心脏搭桥术后压力性损伤的风险预测模型[J].局解手术学杂志,2026,35(02):93-97.
ZHU Xin-yue,XU Tian-ning,SI Lin-jie,et al.Construction of a risk prediction model for pressure injuries after coronary artery bypass grafting based on DynNom dynamic score[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):93-97.
朱鑫玥,徐天宁,司林杰等.基于DynNom动态评分构建心脏搭桥术后压力性损伤的风险预测模型[J].局解手术学杂志,2026,35(02):93-97. DOI： 10.11659/jjssx.08E025110.
ZHU Xin-yue,XU Tian-ning,SI Lin-jie,et al.Construction of a risk prediction model for pressure injuries after coronary artery bypass grafting based on DynNom dynamic score[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):93-97. DOI： 10.11659/jjssx.08E025110.
摘要
目的
2
分析心脏搭桥术后压力性损伤的危险因素，建立心脏搭桥术后压力性损伤的列线图模型。
方法
2
选取2021年2月至2024年12月我院收治的262例心脏搭桥术患者作为研究对象，根据心脏搭桥术后压力性损伤发生情况将其分为压力性损伤组和无压力性损伤组。比较2组患者的临床资料。采用
LASSO
分析筛选心脏搭桥术后压力性损伤的预测因素，采用
Logistic
回归模型筛选心脏搭桥术后压力性损伤的危险因素，采用R4.2.3软件建立心脏搭桥术后压力性损伤的列线图模型，并对心脏搭桥术后压力性损伤的列线图模型进行验证。
结果
2
262例心脏搭桥术患者中，有73例（27.86%）发生压力性损伤。2组患者的体外循环、使用血管活性药物、手术时间、肾功能不全、糖尿病、肥胖等资料比较，差异均有统计学意义（
P
<
0.05）。
Logistic
回归分析结果显示，体外循环、使用血管活性药物、手术时间≥4 h、肾功能不全、糖尿病、肥胖均是心脏搭桥术后压力性损伤的危险因素（
P
<
0.05）。心脏搭桥术后压力性损伤的列线图模型的受试者工作特征曲线下面积是0.796（95%
CI
：0.738~0.854）；
Hosmer-Lemeshow
检验结果显示
χ
2
=2.128，
P
=0.952，校正曲线的预测值和实际值基本拟合；决策曲线分析显示阈值概率是5%~100%时，列线图对心脏搭桥术后压力性损伤的预测具有良好的获益值。
结论
2
体外循环、使用血管活性药物、手术时间≥4 h、肾功能不全、糖尿病、肥胖均是心脏搭桥术后压力性损伤的危险因素，心脏搭桥术后压力性损伤的列线图模型准确性尚可。
Abstract
Objective
2
To analyze the risk factors of pressure injuries after coronary artery bypass grafting and establish a nomogram model for pressure injuries after coronary artery bypass grafting.
Methods
2
A total of 262 patients who underwent co
ronary artery bypass grafting in our hospital from February 2021 to December 2024 were selected as the research subjects and they were divided into the pressure injury group and the non-pressure injury group based on the occurrence of pressure injuries after coronary artery bypass grafting. The clinical data of patients in the two groups were compared.
LASSO
analysis was used to screen the predictive factors of pressure injuries after coronary artery bypass grafting，
Logistic
regression model was used to screen the risk factors of pressure injuries after coronary artery bypass grafting. A nomogram model for pressure injuries after coronary artery bypass grafting was established by R4.2.3 software， and the nomogram model of pressure injuries after coronary artery bypass grafting was verified.
Results
2
Among 262 patients who underwent coronary artery bypass grafting， 73 cases （27.86%） developed pressure injuries. There were statistically significant differences in terms of cardiopulmonary bypass， use of vasoactive drugs， operation time， renal insufficiency， diabetes and obesity between the two groups （
P
<
0.05）.
Logistic
regression analysis showed that cardiopulmonary bypass， use of vasoactive drugs， operation time ≥ 4 hours， renal insufficiency， diabetes and obesity were the risk factors for pressure injuries after coronary artery bypass grafting （
P
<
0.05）. The
area under the
receiver operating characteristic curve
of the nomogram model for pressure injuries after coronary artery bypass grafting was 0.796 （95%
CI
： 0.738 to 0.854）；
Hosmer
-
Lemeshow
test results showed that
χ
2
=2.128，
P
=0.952， and the predicted value and actual value of the calibration curve were basically fitted； the
decision curve analysis
showed that when the threshold probability was 5% t
o 100%， the nomogram had good benefit value for predicting pressure injuries after coronary artery bypass grafting.
Conclusion
2
Cardiopulmonary bypass， use of vasoactive drugs， operation time ≥ 4 hours， renal insufficiency， diabetes， and obesity are the risk factors for pressure injuries after coronary artery bypass grafting， and the nomogram model for pressure injuries after coronary artery bypass grafting has acceptable accuracy.
关键词
Keywords
references
Gökçe E ， Alptekin D ， Gezer D ， et al . Outcomes of incentive spirometry for patients undergoing coronary artery bypass surgery：a randomised controlled trial ［J］. Int J Nurs Pract ， 2025 ， 31 （ 2 ）： e70011 . doi： 10.1111/ijn.70011 http://dx.doi.org/10.1111/ijn.70011 .
Ishrat M ， Zaidi S . Postoperative posterior reversible encephalopathy syndrome after coronary artery bypass surgery ［J］. J Coll Physicians Surg Pak ， 2023 ， 33 （ 12 ）： 1467 - 1468 . doi： 10.29271/jcpsp.2023. 12.1467 http://dx.doi.org/10.29271/jcpsp.2023.12.1467 .
Fähndrich C ， Gemperli A ， Baumberger M ， et al . Risk factors of major complications after flap surgery in the treatment of stage Ⅲ and Ⅳ pressure injury in people with spinal cord injury/disorder：a retrospective cohort study ［J］. Spinal Cord ， 2024 ， 62 （ 1 ）： 34 - 41 . doi： 10.1038/s41393-023-00944-9 http://dx.doi.org/10.1038/s41393-023-00944-9 .
Sahay A ， Willis E ， Yu S . Pressure injury education for older adults and carers living in community settings：a scoping review ［J］. Int Wound J ， 2024 ， 21 （ 5 ）： e14894 . doi： 10.1111/iwj.14894 http://dx.doi.org/10.1111/iwj.14894 .
褚万立 ， 郝岱峰 . 美国国家压疮咨询委员会2016年压力性损伤的定义和分期解读 ［J］. 中华损伤与修复杂志 （电子版）， 2018 ， 13 （ 1 ）： 64 - 68 . doi： 10.3877/cma.j.issn.1673-9450.2018.01.014 http://dx.doi.org/10.3877/cma.j.issn.1673-9450.2018.01.014 .
Taner T ， Pala AA ， Camci S ， et al . The value of atrial electromechanical delay in predicting atrial fibrillation development after coronary artery bypass surgery ［J］. Echocardiography ， 2022 ， 39 （ 1 ）： 28 - 36 . doi： 10.1111/echo.15237 http://dx.doi.org/10.1111/echo.15237 .
Charlton E ， Atkins KJ ， Evered L ， et al . The long‐term incidence of chronic post‐surgical pain after coronary artery bypass surgery：a prospective observational study ［J］. Eur J Pain ， 2024 ， 28 （ 4 ）： 599 - 607 . doi： 10.1002/ejp.2203 http://dx.doi.org/10.1002/ejp.2203 .
Eriksson KE ， Eidhagen F ， Liska J ， et al . Effects of inorganic nitrate on ischaemia-reperfusion injury after coronary artery bypass surgery ［J］. Br J Anaesth ， 2021 ， 127 （ 4 ）： 547 - 555 . doi： 10.1016/j.bja.2021. 06.046 http://dx.doi.org/10.1016/j.bja.2021.06.046 .
尹珊珊 ， 王惠平 ， 张晓 ， 等 . 达芬奇机器人辅助非体外循环冠状动脉旁路移植术的护理 ［J］. 护理学报 ， 2023 ， 30 （ 18 ）： 71 - 74 . doi： 10.16460/j.issn1008-9969.2023.18.071 http://dx.doi.org/10.16460/j.issn1008-9969.2023.18.071 .
李振刚 ， 王亚婷 ， 祁进芳 ， 等 . 三种压力性损伤评估量表对ICU体外循环术后患者压力性损伤预测能力比较 ［J］. 中国医药导报 ， 2022 ， 19 （ 9 ）： 50 - 54 . doi： 10.20047/j.issn1673-7210.2022.09.009 http://dx.doi.org/10.20047/j.issn1673-7210.2022.09.009 .
陈慧慧 ， 陆真 . 个体化预测心脏瓣膜置换术后压力性损伤发生风险的列线图模型构建 ［J］. 实用心脑肺血管病杂志 ， 2021 ， 29 （ 12 ）： 40 - 46 . doi： 10.12114/j.issn.1008-5971.2021.00.274 http://dx.doi.org/10.12114/j.issn.1008-5971.2021.00.274 .
樊小倩 ， 孙晴 ， 仲怀凤 ， 等 . 体外循环心脏术后并发压力性损伤预测模型的建立 ［J］. 蚌埠医学院学报 ， 2022 ， 47 （ 12 ）： 1752 - 1755 . doi： 10.13898/j.cnki.issn.1000-2200.2022.12.030 http://dx.doi.org/10.13898/j.cnki.issn.1000-2200.2022.12.030 .
0
浏览量
4
下载量
0
CSCD
- 网络PDF下载
- WORD下载
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 技术支持由北京北大方正电子有限公司提供 京ICP备09064830号-19
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
