SMSA评分对结肠侧向发育型肿瘤内镜黏膜下剥离术术后相关并发症的预测价值研究  

Predictive value of SMSA scores in endoscopic submucosal dissection surgery⁃related complications of colonic lateral growth tumors

作　　者：沈璐[1] 叶小峰 王晶[1] 潘丹烨 Shen Lu;Ye Xiaofeng;Wang Jing;Pan Danye(Department of Spleen and Stomach Diseases,Changzhou Hospital of Traditional Chinese Medicine,Changzhou 213000,China)

机构地区：[1]常州市中医医院脾胃病科,江苏常州213000

出　　处：《海军医学杂志》2023年第3期260-264,共5页Journal of Navy Medicine

摘　　要：目的探究大小、形态、部位和可及性(size,morphology,size,access,SMSA)评分对结肠侧向发育型肿瘤内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)术后相关并发症的预测价值。方法选取2018年11月至2022年2月常州市中医医院收治的170例行ESD术后治疗的结肠侧向发育型肿瘤患者为研究对象。术前1 d评估SMSA评分,统计术后7 d结肠侧向发育型肿瘤ESD术后相关并发症发生情况,并依据是否发生ESD术后相关并发症分为发生组和未发生组。对比发生组和未发生组患者的临床资料。Logistic多因素回归分析影响结肠侧向发育型肿瘤患者发生ESD术后相关并发症的危险因素。制作受试者操作特征(receiver operating characteristic,ROC)曲线,以曲线下面积(area under curve,AUC)分析SMSA评分对结肠侧向发育型肿瘤患者发生ESD术后相关并发症的预测价值。结果结肠侧向发育型肿瘤患者ESD术后相关并发症发生率为17.65%。发生组合并高血压占比、合并高血脂症占比、年龄、术后时间及SMSA评分均高于未发生组(P<0.05)。Logistic多因素分析结果显示,合并高血压、合并高血脂症及SMSA评分均为影响结肠侧向发育型肿瘤患者发生ESD术后相关并发症的危险因素(OR=2.759、2.807、3.401,P<0.05)。ROC分析显示,SMSA评分对结肠侧向发育型肿瘤患者发生ESD术后相关并发症预测的最佳截断点为12分,灵敏度、特异度分别为83.33%,82.86%,AUC为0.895。结论SMSA评分对结肠侧向发育型肿瘤ESD术后相关并发症的预测价值较高,可作为术前临床评估该类患者ESD术后相关并发症发生的重要参考指标。Objective To explore the predictive value of the size,morphology,site,access(SMSA)scores for the complications associated with endoscopic submucosal dissection(ESD)surgery in laterally developing colon tumors.Methods A total of 85 patients with laterally developing colon tumors who underwent ESD in Changzhou Traditional Chinese Medicine Hospital from November 2018 to February 2022 were selected as research subjects.One day before surgery,the SMSA scores were evaluated,and the incidence of complications related to ESD surgery for colonic lateral growth tumors was statistically analyzed 7 days after surgery.Then,the patients were divided into the complication group and the non⁃complication group,depending on whether ESD surgery⁃related complications had developed.Clinical data of the patients in woth groups were compared between the 2 groups.Logistic multivariate regression analyzed influencing risk factors of ESD surgery⁃related complications in the patients with colonic lateral development tumors.The receiver operating characteristic curve(ROC)was plotted,and the area under the curve(AUC)was used to analyze the predictive value of the SMSA scores in the incidence of ESD surgery⁃related complications in the patients with colonic lateral development tumors.Results The incidence of postoperative complications related to ESD surgery in the patients with colonic lateral growth tumors was 17.65%.The proportion of combined hypertension,the proportion of combined hyperlipidemia,the age,the surgical time and SMSA scores were all higher than those of the non⁃complication group(P<0.05).Logistic multivariate analysis showed that hypertension,hyperlipidemia,and SMSA scores were all risk factors affecting ESD surgery⁃related complications in the patients with colonic lateral development tumors(OR=2.759,2.807,3.401)(P<0.05).ROC analysis showed that the best cut⁃off point of SMSA scores for predicting ESD surgery⁃related complications in the patients with colonic lateral developmental tumors was 12.The sensitivit

关 键 词：SMSA评分 结肠侧向发育型肿瘤 内镜黏膜下剥离术 并发症 预测 

分 类 号：R735.3[医药卫生—肿瘤]