胃肠道间质瘤患者行内镜黏膜下剥离术中穿孔的个性化预警模型的建立OA

Objective:To explore the independent risk factors of perforation in patients with gastrointestinal stromal tumor(GIST)undergoing endoscopic submucosal dissection(ESD),and to construct an early warning model.Method:The case data of 168 GIST patients with ESD treated in our hospital from October 2018 to October 2020 were retrospectively analyzed.According to whether perforation occurred during operation,they were divided into perforated group and non perforated group.The general data and clinicopathological characteristics of the two groups were compared.The independent risk factors of perforation in GIST patients were screened by univariate and logistic regression analysis.The corresponding nomogram model is established and verified.Result:Through logistic regression analysis of the risk factor data of patients,it can be seen that the operation time≥90 min,the amount of bleeding≥45 mL,the diameter of the lesion≥2 cm,the location of the lesion in the stomach or rectum,and the depth of infiltration are the independent risk factors of perforation in GIST patients during ESD.Based on these five risk factors,a nomogram model was established to predict the perforation of GIST patients during ESD.The calibration verification results showed that the curve coincidence between the predicted value and the measured value was high,indicating that the prediction model had better accuracy than the measured value.At the same time,bootstrap internal verification results show that the C-index index is as high as 0.845(95%CI:0.700～0.990),suggesting that the accuracy and discrimination of the model are good.Conclusion:Based on the above risk factors,medical staff can individually predict and evaluate the risk of perforation during ESD in GIST patients according to the nomogram model established in this study,so as to reduce the incidence of complications such as perforation,improve the success rate of operation and improve the prognosis of patients.