决策树模型与Logistic回归模型在产后尿潴留发生影响因素分析中的作用
郭学齐 闫贵贞 张彩霞 陈景娟
浙江省丽水市人民医院产科,浙江丽水 323000
The role of decision tree model and Logistic regression model in postpartum urinary retention influencing factors analysis
GUO Xueqi YAN Guizhen ZHANG Caixia CHEN Jingjuan
Department of Obstetrics, Lishui People′s Hospital, Zhejiang Province, Lishui 323000, China
摘要 目的 探讨决策树模型与Logistic回归模型在产后尿潴留(PUR)发生影响因素分析中的作用。 方法 收集2014年1月1日~2017年12月31日在浙江省丽水市人民医院(以下简称“我院”)经阴道分娩后发生PUR的180例产妇作为病例组,随机选取同期于我院经阴道分娩且未发生PUR的200例产妇作为对照组。采用决策树模型与Logistic回归模型回顾性分析PUR发生的相关影响因素。 结果 决策树模型和多因素Logistic回归模型分析均显示分娩镇痛(P = 0.047)、产钳助产(P = 0.001)以及会阴侧切(P < 0.001)是发生PUR的独立危险因素。此外,Logistic回归模型分析结果还提示巨大儿(P = 0.023)是PUR的影响因素,而决策树模型中未提示其对PUR的发生有影响。 结论 PUR的影响因素众多,决策树模型和Logistic回归模型互为补充,可从不同方面描述PUR发生的影响因素,为进一步制订预防措施提供参考依据。
关键词 :
决策树模型 ,
产后尿潴留 ,
影响因素 ,
Logistic回归模型
Abstract :0bjective To investigate the role of decision tree model and Logistic regression model in postpartum urinary retention (PUR) influencing factors analysis. Methods From January 1, 2014 to December 31, 2017, 180 puerpera with PUR after vaginal delivery in Lishui People′s Hospital of Zhejiang Province ("our hospital" for short) were selected as case group, and 200 puerpera who without PUR in our hospital at the same period were selected randomly as control group. Decision tree model and Logistic regression model were used to determine influential factors for PUR. Results Decision tree model and Logistic regression model indicated that delivery analgesia (P = 0.047), forceps delivery (P = 0.001) and episiotomy (P < 0.001) were independent risk factors of PUR, and fetal macrosomia (P = 0.023) was also the influencing factor in the Logistic regression model, but the decision tree model did not indicate its influence. Conclusion There are many factors influencing PUR. Decision tree model and Logistic regression model are complementary to each other, which can describe the factors from different aspects, and provide basis and reference for the further formulation of preventive measures.
Key words :
Decision tree model
Postpartum urinary retention
Influencing factors
Logistic regression model
基金资助: 国家卫生计生委医药卫生科技发展研究中心资助项目(W2015CAE044)。
[1] Oh J,Kim S,Shin J,et al. Risk factors for acute postpartum urinary retention after vaginal delivery:focus on episiotomy direction [J]. J Matern Fetal Neonatal Med,2016, 29(3):408-411.
[2] 石翠霞,马乐.产后尿潴留高危因素及防治进展[J].中国生育健康杂志,2017,28(3):296-298,301.
[3] Stanley A,Conner B. Implementing a clinical practice guideline to manage postpartum urinary retention [J]. J Nurs Care Qual,2015,30(2):175-180.
[4] Mulder F,Hakvoort R,De Bruin J,et al. Long-term micturition problems of asymptomatic postpartum urinary retention:a prospective case-control study [J]. Int Urogynecol J,2018,29(4):481-488.
[5] Polat M,■entürk MB,Pulato■lu ?覶,et al. Postpartum urinary retention:Evaluation of risk factors [J]. Tur J Obstet Gynecol,2018,15(2):70-74.
[6] 帅健,李丽萍,陈业群.决策树模型与Logistic回归模型在伤害发生影响因素分析中的作用[J].中华疾病控制杂志,2015,19(2):185-189.
[7] 郭慧敏,杜军,黄路非,等.决策树和logistic回归评价非重症社区获得性肺炎患者住院费用[J].中国病案,2017, 18(7):50-52.
[8] Amini P,Maroufizadeh S,Samani RO,et al. Prevalence and Determinants of Preterm Birth in Tehran,Iran:A Comparison between Logistic Regression and Decision Tree Methods [J]. Osong Public Health Res Perspect,2017,8(3):195-200.
[9] Mallouli M,Derbel M,Ingrid A,et al. Associated outcomes to fetal macrosomia:effect of maternal diabetes [J]. Tunis Med,2017,95(2):120-125.
[10] Neron M,Allègre L,Huberlant S,et al. Impact of systematic urinary catheterization protocol in delivery room on covert postpartum urinary retention:a before-after study [J]. Sci Rep,2017,7(1):17 720.
[11] 陈红珍.产后尿潴留的发生原因及护理研究进展[J].护理研究,2016,30(16):1924-1927.
[12] 仇春波,陈洁.分娩镇痛产后尿潴留的临床观察[J].现代实用医学,2013,25(3):352-353.
[13] 殷素华.阴道分娩后尿潴留的相关因素分析及盆底康复干预的效果研究[J].中国妇幼保健,2017,32(10):2093-2095.
[14] Mulder FE,Hakvoort RA,Schoffelmeer MA,et al. Postpartum urinary retention:a systematic review of adverse effects and management [J]. Int Urogynecol J,2014,25(12):1605-1612.
[15] 石翠霞.产后尿潴留的危险因素分析[D].北京:首都医科大学,2017.
[16] Tiberon A,Carbonnel M,Vidart A,et al. Risk factors and management of persistent postpartum urinary retention [J]. J Gynecol Obstet Hum Reprod,2018,47(9):437-441.
[17] 杨同文,熊巍,任自刚,等.系统评价硬膜外分娩镇痛时机对初产妇分娩过程的影响:Meta分析[J].临床和实验医学杂志,2018,17(11):1206-1212.
[18] Kekre AN,Vijayanand S,Dasgupta R,et al. Postpartum urinary retention after vaginal delivery [J]. Int J Gynaecol Obstet,2011,112(2):115.
[19] Cavkaytar S,Kokanal?覦 M,Baylas A,et al. Postpartum urinary retention after vaginal delivery:Assessment of risk factors in a case-control study [J]. J Turk Ger Gynecol Assoc,2014,15(3):140-143.
[20] Chen W,Xie X,Wang J,et al. A comparative study of logistic model tree,random forest,and classification and regression tree models for spatial prediction of landslide susceptibility [J]. Catena,2017,151:147-160.
[21] Pak K,Kim K,Kim MH,et al. A decision tree model for predicting mediastinal lymph node metastasis in non-small cell lung cancer with F-18 FDG PET/CT [J]. PLoS One,2018,13(2):e0193403.
[22] 刘兵,李苹,朱玫烨,等.决策树模型与logistic回归模型在胃癌高危人群干预效果影响因素分析中的应用[J].中国卫生统计,2018,35(1):70-73.
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