中国当代医药2025，Vol.32Issue(22)：15-19,28,6.DOI:10.3969/j.issn.1674-4721.2025.22.03
基于随机森林分析混合痔术后患者早期疼痛灾难化的影响因素及其对策
Analysis of the influencing factors of early pain catastrophization in pa-tients after mixed hemorrhoid surgery based on random forest analysis and its nursing countermeasures
摘要
Abstract
Objective Based on the random forest algorithm,the influencing factors of early pain catastrophization in pa-tients after mixed hemorrhoids surgery were analyzed,and corresponding nursing countermeasures were given according to the influencing factors.Methods A total of 175 patients who underwent mixed hemorrhoid surgery at the Affiliated Hospital of Jiujiang University from August 2022 to February 2024 were selected as the training set.The pain catastrophizing scale(PCS)was used to evaluate the catastrophization pain level of the patients one day after mixed hemorrhoid surgery.According to the results,they were divided into the catastrophization pain group(n=81)and the non-catastrophization pain group(n=94).In addition,75 patients who underwent mixed hemorrhoid surgery from February to August 2024 were selected as the validation set in a ratio of 7∶3 between the training set and the validation set.Patient data were collected.After screening for relevant influencing factors through univariate and multivariate analyses,a logistic regression model and a ran-dom forest model for early pain catastrophization in patients after mixed hemorrhoid surgery were constructed,and external validation was conducted using a validation set.The predictive efficacy of these two models was evaluated by the ROC curve.Results Among the 175 patients,the incidence of pain catastrophy was 46.29％(81/175).The univariate results showed that there were statistically significant differences in age,educational level,visual analogue scale(VAS)score,negative emotion score,positive emotion score,and pain coping strategy questionnaire score between the two groups(P＜0.05).Multivariate analysis showed that age(β=0.140,OR=1.150,95％CI:1.086-1.218),VAS score(β=1.874,OR=6.516,95％CI:4.006-10.600),and negative emotion score(β=0.198,OR=1.219,95％CI:1.119-1.328)were risk factors for early pain catastrophization in patients after mixed hemorrhoid surgery.Positive emotion score(β=-0.239,OR=0.788,95％CI:0.692-0.896),educational level(β=-1.037,OR=0.355,95％CI:0.218-0.576)and the score of the pain coping strategy questionnaire(β=-0.070,OR=0.932,95％CI:0.904-0.961)were protective factors for early pain catastrophization in pa-tients after mixed hemorrhoids surgery(P＜0.05).In the logistic model,the sensitivities of the training set and the validation set were 0.741 and 0.909 respectively,the specificities were 0.936 and 0.830 respectively,and the AUCs were 0.922 and 0.896 respectively.In the random forest model,the sensitivities of the training set and the validation set were 0.988 and 0.955 respectively,the specificities were 0.979 and 0.868 respectively,and the AUCs were 0.997 and 0.947 respectively.The predictive efficacy of the random forest model was higher than that of the logistic model.In the random forest model,the order of importance of the independent influencing factors for the catastrophizing of early pain in patients after mixed hemorrhoid surgery was:VAS score＞age＞pain coping strategy questionnaire score＞positive emotion score＞educational level＞negative emotion score.Conclusion The random forest model has better efficacy than the logistic model in predicting the risk of early pain catastrophization in patients after mixed hemorrhoids surgery.It can provide better risk assessment for patients and effectively guide clinical decision-making.关键词
随机森林/混合痔术/疼痛灾难化/护理对策Key words
Random forest/Mixed hemorrhoid surgery/Catastrophization of pain/Nursing strategies分类
医药卫生引用本文复制引用
周冬霞,柳菲,王琛,王园,朱立霞..基于随机森林分析混合痔术后患者早期疼痛灾难化的影响因素及其对策[J].中国当代医药,2025,32(22):15-19,28,6.基金项目
江西省卫生健康委科技计划项目(202212020). （202212020）
