目的 构建青少年特发性脊柱侧凸（adolescent idiopathic scoliosis，AIS）患者术后首次离床活动发生体位性低血压（orthostatic hypotension，OH）的风险预测模型，为加快其术后康复速度提供指导。方法 2023年1月至2025年6月，以便利抽样法选取南京某医院术后AIS患者500例为研究对象,以Logistic回归分析确定其首次离床活动发生OH的影响因素并建立列线图；以受试者工作特征(receiver operator characteristic,ROC)曲线、校准曲线、临床模型决策曲线等验证模型预测效能。结果 有47例（9.4%）AIS患者术后首次离床活动发生OH；术后卧床时间、接受体位适应性训练、坐位血压、疼痛情况、睡眠障碍情况和焦虑程度等均是其发生OH的主要影响因素（均 P ＜0.05）。ROC曲线、决策曲线和校准曲线验证模型预测效能较优。结论 AIS患者术后首次离床活动存在OH发生风险，构建的AIS术后首次离床活动发生OH的风险预测模型有较好的预测效率和临床适用性。

Objective To develop a risk prediction model for orthostatic hypotension (OH) during first postoperative ambulation in adolescent idiopathic scoliosis (AIS) patients,and provide guidance for postoperative rehabilitation.Methods A total of 500 postoperative AIS patients were enrolled by convenience sampling from a Nanjing hospital between January 2023 and June 2025.Logistic regression was used to identify OH risk factors,and a nomogram was constructed.Model performance was validated by receiver operator characteristic (ROC) curve,calibration curve,and decision curve analysis.Results OH occurred in 47 patients (9.4%).Key risk factors included postoperative bed rest duration,posture adaptation training,sitting blood pressure,pain,sleep disturbance,and anxiety (all P ＜0.05).The model showed good predictive efficacy. Conclusions AIS patients face OH risk during first postoperative ambulation.The established prediction model has favorable predictive efficiency and clinical applicability.

R473.72

国家自然科学基金（82002260）