现代妇产科进展2025，Vol.34Issue(10)：738-745,8.DOI:10.13283/j.cnki.xdfckjz.2025.10.003
剖宫产术后恶心呕吐风险预测模型的构建及验证
Development and validation of a risk predictive model for nausea and vomiting after ce-sarean section
摘要
Abstract
Objective:To explore the influencing factors of nausea and vomiting in par-turient after cesarean section,and to construct a risk prediction model and verify its validity.Methods:487 postpartum women who had cesarean sections in a hospital in Wenzhou City be-tween June 2023 and October 2023 were chosen as the modelling group using the cluster sam-pling approach,224 postpartum women who had cesarean sections between November 2023 and December 2023 were chosen as the external validation group.The patients were divided into two groups according to whether nausea and vomiting occurred 24 hours after operation.The data of the two groups were compared.The influencing factors of nausea and vomiting were analyzed by univariate analysis and logistic regression analysis,the predictive model was established and plotted with the results.The predictive effect of the model was verified by Discrimination,Cali-bration and Clinical Utility.Results:The incidence of nausea and vomiting after cesarean sec-tion was 20.12％,the multivariate analysis showed that nausea and vomiting during pregnancy≥7points(OR=1.782,95％CI:1.032～3.077,P=0.038)and history of nausea and vomi-ting after cesarean section(OR=5.574,95％CI:1.413～21.983,P=0.014),motion sickness in pregnancy(OR=3.381,95％CI:1.837～6.222,P<0.001),and intraoperative nausea and vomiting(OR=5.863,95％CI:3.368～10.206,P<0.001)was a risk factor for nausea and vomiting after cesarean section,and preoperative fasting(OR=0.184,95％CI:0.065～0.521,P=0.001),intraoperative use of ondansetron 4mg(OR=0.312,95％CI:0.143～0.684,P=0.004),and analgesic pump(OR=0.512,95％CI:0.286～0.918,P=0.025),were protec-tive factors for nausea and vomiting after cesarean section.The area under the ROC curve of the prediction model AUC(95％CI)=0.8486(0.81～0.89).The validation results of the model-ling group reveal that the AUC value is 0.854,indicating good model discrimination and Hos-mer-Lemeshow test:P=0.497≥0.05,internal validation used the Bootstrap self-sampling method,and the findings revealed that AUC=0.845.Hosmer-Lemeshow test:P=0.3605≥0.05.The outcomes showed AUC=0.860 and Hosmer-Lemeshow test:P=0.10≥0.05.Con-clusion:The predictive model has a good predictive effect on nausea and vomiting of parturient after cesarean section.关键词
剖宫产术/术后恶心呕吐/影响因素/预测模型Key words
Caesarean section/Postoperative nausea and vomiting/Influence factors/Predictive models分类
医药卫生引用本文复制引用
黄一汝,林海燕..剖宫产术后恶心呕吐风险预测模型的构建及验证[J].现代妇产科进展,2025,34(10):738-745,8.基金项目
温州市医药卫生科研项目(No:2024063) （No:2024063）
