胚胎停止发育发生风险预测模型的构建及基于风险因素的预防性护理效果研究

Construction of risk prediction model for embryonic arrest and study effect of preventive nursing based on risk factors

目的 构建胚胎停止发育发生风险的预测模型,以及研究基于风险因素的预防性护理效果。方法 回顾性分析2019年1月至2021年12月在万宁市人民医院接受检查的100例胚胎停止发育者(病例组)以及100例胚胎发育状态正常者(对照组)。采用Logistic回归分析探究胚胎停止发育的影响因素,采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析风险预测模型的预测效能。另选择2021年1-12月在万宁市人民医院产检的200例孕妇,按照随机数字表法分为常规护理组(100例)以及预防性护理组(100例),其中预防性护理组基于风险因素开展针对性护理,比较两组胚胎停止发育情况。结果 病例组年龄、空腹血糖均处于较高水平,且吸烟、熬夜、睡眠不足发生率高于对照组(P<0.05)。Logistic回归分析显示,年龄、空腹血糖、吸烟、熬夜、睡眠情况是胚胎停止发育的影响因素(P<0.05)。风险预测模型预测胚胎停止发育的曲线下面积(Area under the curve,AUC)为0.857(0.777~0.937),敏感度、特异度分别为78.0%(78/100)、87.0%(87/100)。预防性护理组的雌二醇(Estradiol, E2)、孕酮(Progesterone, PRGE)水平明显高于常规护理组,而促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)以及胚胎停止发育率明显低于常规护理组(P<0.05)。结论 年龄、空腹血糖、吸烟、熬夜、睡眠情况是胚胎停止发育的影响因素,基于以上因素建立的风险预测模型具有良好的预测价值,可指导临床采取预防性护理措施以降低胚胎停止发育风险。

Objective To construct a prediction model for the risk of embryonic arrest and study the effect of preventive nursing based on risk factors.Methods A retrospective analysis was performed on 100 cases with embryonic arrest(case group)and 100 cases with normal embryonic development status(control group)who were examined in the hospital from January 2019 to December 2021.Logistic regression analysis was used to explore the influencing factors of embryonic arrest.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of the risk prediction model.In addition,200 cases of antenatal examination in the hospital from January 2021 to December 2021 were selected and divided into routine care group(100 cases)and preventive care group(100 cases)with the method of random control table.The preventive nursing group was given targeted nursing based on risk factors,and the situation of embryo arrest was compared between the two groups.Results The age and fasting blood glucose of the case group was staying at a higher level,and the incidence of smoking,staying up late and sleep deprivation was higher than that of the control group(P<0.05).Logistic regression analysis showed that age,fasting blood glucose,smoking,staying up late and sleep status were the influencing factors of embryo arrest(P<0.05).The AUC of the risk prediction model was 0.857(0.777~0.937),and the sensitivity and specificity were 78.0%(78/100)and 87.0%(87/100),respectively.The levels of E2 and PRGE in the preventive nursing group were significantly higher than those in the routine nursing group,while TSH,FT3,FT4 and the incidence of embryo arrest were significantly lower than those in the routine nursing group(P<0.05).Conclusion Age,fasting blood glucose,smoking,staying up late and sleeping condition are the influencing factors of embryonic arrest.The risk prediction model based on the above factors have a good predictive value,which can guide clinical preventive nursing measures to reduce the risk of embryonic arrest.