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- Title
高原地区内镜微创保胆取石术后结石复发新型预测列线图的构建和验证.
- Authors
梅学鹏; 陈小彬; 皮世政; 陈屹冲; 星军华; 王海久; 高帅; 周瀛
- Abstract
Objective To analyze the factors related to stone recurrence after endoscopic minimally invasive gallstone preservation and stone removal, and establish a nomogram model for predicting the risk of postoperative stone recurrence based on independent risk factors. Methods Retrospective analysis from January 2012 to January 2018 The clinical data of 144 patients with gallbladder stones who underwent endoscopic minimally invasive gallstone preservation and stone removal in the Affiliated Hospital of Qinghai University. Patients were divided into recurrence-free group (n=130) and recurrence group (n=14) according to the recurrence of stones after surgery. The χ2 test was used to compare the count data between the two groups. The independent risk factors of postoperative stone recurrence were evaluated by LASSO and logistic regression analysis, and the corresponding nomogram prediction model was drawn according to the regression coefficient. The reliability of the prediction nomogram was evaluated by drawing the calibration curve. The Harrell consistency index was used to quantify the discriminative performance of the predictive nomogram; the receiver operating characteristic curve was used to evaluate the sensitivity and specificity of the predictive model, and the area under the curve (AUC) was calculated. Results 144 patients with endoscopic microscopy The invasive and preserving gallbladder removal operations were successful, and 14 cases (9.7%) had recurrence of stones after surgery. Through multivariate analysis, four independent risk factors affecting recurrence were identified, which were family history (OR=3.245, 95%CI: 0.752~13.567, P=0.104), regularity of diet (OR=3.752, 95%CI: 1.067~14.141, P=0.041), uniformity of stones (OR=5.871, 95%CI: 1.636~25.390, P= 0.010) and drug compliance (OR=0.225, 95%CI: 0.057~0.799, P=0.024). The consistency coefficient (C-index) of the nomogram model in the modeling sample is 0.835 (95%CI: 0.732) ~0.938), the C-index in the verification sample is 0.7925, indicating that the nomogram model of this study has good accuracy and discrimination. The AUC value of the predicted nomogram is 0.835, indicating that the nomogram has a higher predictive value .Conclusion Family history, regularity of diet, uniformity of gallstones, and drug compliance are independent risk factors for stone recurrence after endoscopic minimally invasive gallstone preservation and removal. The nomogram established based on the above independent risk factors can help predict Risk of recurrence of stones after surgery.
- Publication
Journal of Clinical Hepatology / Linchuang Gandanbing Zazhi, 2021, Vol 37, Issue 3, p648
- ISSN
1001-5256
- Publication type
Article
- DOI
10.3969/j.issn.1001-5256.2021.03.028