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| 骨科下肢手术患者术后恐动症的影响因素及列线图预测模型的构建 |
| Analysis of factors influencing postoperative akinetophobia in orthopedic lower limb surgery patients and construction of a risk prediction Nomogram model |
| 投稿时间：2025-06-25 |
| DOI：10.3969/j.issn.1000-0399.2026.04.003 |
| 中文关键词: 恐动症 骨科手术 睡眠质量 自我效能 下肢 预测模型 列线图 |
| 英文关键词: Akinesia Sleep quality Orthopedic surgery Self-efficacy Lower limb Predictive model Nomogram |
| 基金项目:合肥市卫生健康委2023年应用医学科研项目（编号：Hwk2023zd018） |
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| 中文摘要: |
| 目的 探讨骨科下肢手术患者术后恐动症的影响因素，并构建风险预测列线图模型。方法 回顾性分析2022年6月至2024年6月合肥市第三人民医院骨科收治的120例下肢手术患者资料，依据恐动症评估量表（TSK）分为发生组（TSK＞37分，n=60）和未发生组（TSK≤37分，n=60）。比较两组临床资料差异，采取多因素logistic回归分析患者术后发生恐动症的影响因素，并据此构建列线图预测模型，采取受试者工作特征（ROC）曲线评价模型预测效能。结果 多因素logistic回归分析显示，匹兹堡睡眠质量指数（PSQI）评分高、疼痛视觉模拟量表（VAS）评分高为这类患者术后发生恐动症的独立危险因素，而自我效能评分高是其保护因素（P＜0.05）。基于上述因素构建的列线图模型预测患者术后发生恐动症的曲线下面积（AUC）为0.968，95% CI：0.943～0.993。结论 PSQI、VAS及自我效能评分是骨科下肢手术患者术后发生恐动症的独立影响因素，基于上述因素构建的列线图模型对术后恐动症具有较高的预测价值。 |
| 英文摘要: |
| Objective To investigate factors influencing postoperative akinetophobia in orthopedic lower limb surgery patients and construct a risk prediction nomogram model. Methods A retrospective study design was employed, utilizing data from 120 orthopedic lower limb surgery patients admitted to our hospital between June 2022 and June 2024. The Tardive Dyskinesia Scale (TSK) was used to assess postoperative dyskinesia. Patients with TSK scores >37 were classified into the occurrence group (n=60), while those with scores ≤37 were assigned to the non-occurrence group (n=60). Clinical data differences between groups were compared. Multivariate logistic regression was used to analyze independent factors influencing postoperative akinesia in orthopedic lower limb surgery patients, enabling construction of a regression model. Receiver operating characteristic (ROC) curves was employed to evaluate predictive performance. Results Postoperative akinesia incidence was 50.00% (60/120). Multivariate logistic regression analysis revealed that the Pittsburgh Sleep Quality Index (PSQI) and Visual Analogue Scale (VAS) for pain were independent risk factors for postoperative akathisia in orthopedic lower limb surgery patients, while selfefficacy score was an independent protective factor (P<0.05). The area under the curve (AUC) for the nomogram model predicting postoperative akathisia based on these factors was 0.968, demonstrating excellent discriminatory ability. Conclusion PSQI, VAS, and self-efficacy scores are independent factors for postoperative akinesia in orthopedic lower limb surgery patients. The nomogram model constructed based on these factors demonstrates high predictive value for postoperative akinesia, providing a reference for early identification of high-risk patients and development of targeted intervention strategies in clinical practice. |
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