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| 泌尿外科全身麻醉手术后导尿管相关膀胱刺激征的危险因素分析及列线图预测模型构建 |
| Risk factor analysis and nomogram prediction model establishment for catheter-related bladder discomfort after urological surgery with general anesthesia |
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| DOI：10.12089/jca.2026.05.006 |
| 中文关键词: 列线图模型 全身麻醉 导尿管相关膀胱刺激征 危险因素 |
| 英文关键词: Nomogram model General anesthesia Catheter-related bladder discomfort Risk factor |
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| 中文摘要: |
目的：探究泌尿外科全身麻醉患者术后导尿管相关膀胱刺激征（CRBD）的危险因素并构建列线图预测模型。
方法：回顾性收集2025年1—7月接受泌尿外科全身麻醉手术且术后留置导尿管的患者临床资料。根据术后是否发生CRBD将患者分为两组：CRBD组和非CRBD组。采用单因素和多因素Logistic回归分析术后CRBD的危险因素，并构建列线图预测模型。绘制受试者工作特征（ROC）曲线，并计算曲线下面积（AUC）评估模型的预测效能。采用Hosmer-Lemeshow检验评估模型的拟合优度。
结果：共纳入患者200例，有126例（63.0%）发生CRBD。多因素Logistic回归分析显示，年龄偏大（OR=1.115，95%CI 1.067～1.166）、术中出血量偏多（OR=1.247，95%CI 1.849～11.161）、静-吸复合麻醉（OR=4.543，95%CI 1.849～11.161）、术中使用右美托咪定（OR=3.070，95%CI 1.492～6.317）是泌尿外科全身麻醉患者术后CRBD的独立危险因素。基于以上因素构建列线图预测模型，预测模型ROC曲线图的AUC为0.818（95%CI 0.759～0.878），敏感性和特异性分别为0.873和0.622。Hosmer-Lemeshow检验显示列线图模型预测值与实际观测值无显著差异，拟合效果良好。
结论：年龄偏大、术中出血量偏多、静-吸复合麻醉、术中使用右美托咪定是泌尿外科全身麻醉患者术后CRBD的独立危险因素，基于上述因素构建的列线图预测模型具有良好的区分度与校准度，能早期识别CRBD高危患者。 |
| 英文摘要: |
Objective: To investigate the risk factors for postoperative catheter-related bladder discomfort CRBD)in patients undergoing urological surgery with general anaesthesia and to construct a nomogram prediction model.
Methods: The clinical data of patients who underwent urological general anesthesia and postoperative indwelling catheter from January to July 2025 were collected retrospectively. The patients were divided into two groups according to whether CRBD occurred after operation: CRBD group and non-CRBD group. Univariate and multivariate logistic regression analysis were used to analyze the risk factors of postoperative CRBD, and a nomogram prediction model was established. The receiver operating characteristic (ROC) curve was drawn, and area under the curve (AUC) was calculated to evaluate the predictive value of the model. The goodness of fit of the model was evaluated by Hosmer-Lemeshaw test.
Results: A total of 200 patients were included, with 126 (63.0%) experiencing CRBD. Multivariate logistic regression analysis revealed that increased age (OR = 1.115, 95% CI 1.067-1.166), more intraoperative blood loss (OR = 1.247, 95% CI 1.849-11.161), combined intravenous and inhalation anaesthesia (OR = 4.543, 95% CI 1.849-11.161), and intraoperative use of dexmedetomidine (OR = 3.070, 95% CI 1.492-6.317) were identified as risk factors for postoperative CRBD in urological patients undergoing general anaesthesia. Based on these factors, a logistic regression prediction model was constructed. The combined predictive AUC for these four factors was 0.818 (95% CI 0.759-0.878), and the sensitivity and specificity were 0.873 and 0.622, respectively. The Hosmer-Lemeshaw test indicated no significant discrepancy between the predicted values from the regression model and the observed values, confirming good model fit.
Conclusion: Increased age, more intraoperative blood loss, combined intravenous and inhalation anaesthesia, and intraoperative use of dexmedetomidine are risk factors for postoperative CRBD in urological patients undergoing urological surgery with general anaesthesia. The nomogram prediction model constructed based on these factors demonstrates good discrimination and calibration, providing an intuitive, quantitative tool for the early clinical identification of high-risk CRBD patients. |
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