痔切除术后肛缘水肿风险模型的构建与验证OA

Objectives To analyze the risk factors for perianal edema following hemorrhoidectomy,construct a nomogram prediction model for forecasting this complication,and validate the model's performance.Methods Clinical data of pa-tients who underwent hemorrhoidectomy at the Affiliated Xuancheng Hospital of Wannan Medical College from March 2023 to April 2025 were retrospectively analyzed.Independent risk factors for post-hemorrhoidectomy perianal edema were screened using LASSO regression and multivariate logistic regression analysis,based on which a nomogram prediction model was constructed.The model's performance was evaluated using the receiver operating characteristic curve,Hosmer-Lemeshow test,Bootstrap method,calibration curve,and decision curve analysis(DCA).Results A total of 333 patients were included and divided into a non-edema group(n=178)and an edema group(n=155)based on the occurrence of postoperative perianal edema.The results showed that female patients,circumferential mixed hemorrhoids,absence of tradi-tional Chinese medicine fumigation and washing therapy,perioperative antibiotic use,and abnormal postoperative defeca-tion were independent risk factors for perianal edema after hemorrhoidectomy.The surgical approach of Milligan-Morgan hemorrhoidectomy combined with automatic elastic band ligation was identified as a protective factor.The area under the curve for the nomogram model was 0.883(95%CI:0.848-0.918).Calibration curves,DCA,and clinical impact curves all con-firmed the model's accuracy and clinical utility.Conclusion This study developed and validated a prediction model for perianal edema following hemorrhoidectomy.The model demonstrates good performance and can assist clinicians in preop-erative risk assessment,enabling early targeted interventions to reduce the incidence of this complication.