胃肠道息肉是常见的胃肠道疾病,涉及源自胃肠道粘膜的局部增生性肿块。
■探讨圈套器辅助内镜黏膜下剥离术(ESD)治疗消化道息肉后迟发性息肉切除术后出血(DPPB)的危险因素,并构建预测DPPB风险的列线图模型。
■共226例2018年5月至2020年11月因胃肠道息肉行圈套器辅助ESD治疗的患者,分为DPPB组(n=10)和非DPPB组(n=216)。
■比较临床数据和内镜数据与DPPB的相关性。采用单因素分析筛选DPPB的影响因素。采用多因素logistic回归分析筛选DPPB的危险因素,用于构建列线图预测模型。
■使用SPSS16.0软件进行统计分析。数字数据表示为百分比(n[%]),单因素分析采用卡方检验。单因素分析的显著因素(P<0.05)包括在多因素logistic回归分析中,有统计学意义(P<0.05)的变量为独立危险因素。利用这些因素构建了预测DPPB风险的列线图模型。采用Bootstrap方法重复采样1000次进行内部验证。用一致性指数(C指数)评价模型的判别,C指数≥0.70代表良好的区分度。双尾P<0.05表示差异有统计学意义。
■单因素和多因素logistic回归分析显示,高血压、息肉位置,息肉直径,息肉形态和术中出血是DPPB的独立危险因素(P<0.05)。用于预测DPPB风险的列线图模型的C指数为0.791,表明良好的区分度。校准曲线表明,预测和实际DPPB发生风险之间的平均绝对误差为0.014,表明准确性高。
■高血压,息肉位置,息肉直径,息肉形态和术中出血是DPPB的独立危险因素,基于这些因素建立的列线图预测模型具有较好的辨别力和准确性。因此,建议对高危人群进行针对性干预,以降低DPPB的发生率.
UNASSIGNED: Gastrointestinal polyps are common gastrointestinal diseases that involve localised hyperplastic masses derived from gastrointestinal mucosa.
UNASSIGNED: To investigate the risk factors of delayed post-polypectomy bleeding (DPPB) after the treatment of gastrointestinal polyps with snare-assisted endoscopic sub-mucosal dissection (ESD) and to construct a nomogram model to predict the risk of DPPB.
UNASSIGNED: A total of 226 patients who underwent snare-assisted ESD for gastrointestinal polyps from May 2018 to November 2020 were divided into DPPB group (n = 10) and non-DPPB group (n = 216).
UNASSIGNED: The correlations of clinical data and endoscopic data with DPPB were compared. Univariate analysis was performed to screen the influencing factors of DPPB. Multivariate logistic regression analysis was used to screen the risk factors of DPPB, which was employed to construct a nomogram prediction model.
UNASSIGNED: SPSS 16.0 software was utilised for statistical analysis. Numerical data were expressed as percentage (n [%]), and Chi-square test was performed for univariate analysis. The significant factors (P < 0.05) in univariate analysis were included in multivariate logistic regression analysis, and the variables with statistical significance (P < 0.05) were considered as independent risk factors. The factors were used to construct a nomogram model for predicting the risk of DPPB. Bootstrap method was employed to perform repeated sampling 1000 times for internal verification. The consistency index (C-index) was used to evaluate the discrimination of the model, and C-index ≥0.70 represented a good discrimination. Two-tailed P < 0.05 indicated that a difference was statistically significant.
UNASSIGNED: Univariate and multivariate logistic regression analyses revealed that hypertension, polyp location, polyp diameter, polyp morphology and intra-operative bleeding were the independent risk factors for DPPB (P < 0.05). The C-index of the nomogram model for predicting the risk of DPPB was 0.791, indicating a good discrimination. The calibration curve showed that the mean absolute error between predicted and actual DPPB occurrence risks was 0.014, indicating a high accuracy.
UNASSIGNED: Hypertension, polyp location, polyp diameter, polyp morphology and intra-operative bleeding are the independent risk factors for DPPB, and the nomogram model established based on these factors for prediction has good discrimination and accuracy. Therefore, it is recommended to perform targeted intervention for high-risk groups to reduce the incidence of DPPB.