青少年腱鞘囊肿治疗后复发情况的影响因素分析  

Analysis of Factors Influencing the Recurrence of Juvenile Ganglion Cysts after Treatment

作　　者：方剑涛 姚瑞蚨 晏文强 FANG Jiantao;YAO Ruifu;YAN Wenqiang(Department of Emergency Surgery,Urumqi First People's Hospital,Urumqi,Xinjiang Uygur Autonomous Region,830000 China)

机构地区：[1]乌鲁木齐市第一人民医院急诊外科,新疆乌鲁木齐830000

出　　处：《系统医学》2024年第9期116-119,123,共5页Systems Medicine

摘　　要：目的分析影响青少年腱鞘囊肿治疗后复发因素,构建风险预测模型,并验证其效能。方法选取2020年1月—2021年7月乌鲁木齐市第一人民医院收治的161例腱鞘囊肿患者作为研究对象,所有患者入院后均予抗炎、镇痛等对症治疗,并根据患者病情选择手术或保守治疗。在患者出院后进行为期1年的随访,根据随访结果,将患者分为复发组(n=32)及对照组(n=124)。分析比较两组患者腱鞘囊肿部位及治疗方式,采用多因素Logistics回归模型分析影响患者预后的因素,采用R软件绘制腱鞘囊肿复发的预测风险列线图,并建立腱鞘囊肿复发的风险预测评分模型。采用Bootstrap抽样法进行重复自抽样500次,对腱鞘囊肿复发风险预测评分模型进行内部验证。根据风险预测评分模型,绘制预测腱鞘囊肿复发的校正曲线,评价二者的一致性。结果复发组患者的年龄、手腕背侧腱鞘囊肿比例、行保守治疗比例均显著高于对照组,差异有统计学意义(P均<0.05);而两组患者囊肿大小比较,差异无统计学意义(P>0.05)。多因素Logistics回归分析显示,年龄(OR=1.888,P=0.002;95%CI:1.260~2.830)、囊肿部位(OR=122.503,P<0.001;95%CI:13.462~1114.809)是影响患者预后的独立危险因素,治疗方式是影响患者预后的独立保护因素(OR=0.135,P=0.028;95%CI:0.023~0.809)。预测腱鞘囊肿复发的列线图显示,风险预测评分模型预测腱鞘囊肿的一致性指数为0.894(95%CI:0.815~0.946),与实际发生情况的平均绝对误差为0.011,两者一致性良好。结论根据年龄、囊肿部位及治疗方法构建的青少年腱鞘囊肿复发预测评分模型,可有效预测腱鞘囊肿复发风险,可供临床判断患者病情,但仍需多中心、大样本研究进一步明确。Objective To analyze the factors influencing the recurrence of juvenile ganglion cysts after treatment,build a risk prediction model and verify its efficacy.Methods A total of 161 patients with tendon sheath cysts admitted to Urumqi First People's Hospital from January 2020 to July 2021 were selected as the study objects.All patients were given symptomatic treatment such as anti-inflammatory and analgesia after admission,and surgical or conservative treatment was selected according to the patients'conditions.Patients were followed up for 1 year after discharge.According to the follow-up results,patients were divided into relapse group(n=32)and control group(n=124).The sites and treatment methods of the two groups of patients were analyzed and compared,and the factors affecting the prognosis of the patients were analyzed using the multi-factor Logistics regression model.The R software was used to draw the prediction risk diagram of the recurrence of the tendon cyst,and the risk prediction score model of the recurrence of the tendon cyst was established.Bootstrap sampling method was used to conduct 500 repeated self-sampling,and internal verification of the score model for predicting the recurrence risk of tendon sheath cyst was carried out.According to the risk prediction score model,the correction curve was drawn to predict the recurrence of tendon sheath cyst,and the consistency of the two was evaluated.Results The age,the proportion of dorsal wrist ganglion cyst and the proportion of conservative treatment in the recurrence group were significantly higher than those in the control group,and the difference was statistically significant(all P<0.05);but there was no statistical significance in the size of the cyst between the two groups(P>0.05).Multivariate logistic regression analysis showed that age(OR=1.888,P=0.002;95%CI:1.260-2.830),cyst site(OR=122.503,P<0.001;95%CI:13.462~1114.809)was an independent risk factor affecting the prognosis of patients,and treatment mode was an independent protective factor affect

关 键 词：腱鞘囊肿 青少年 复发 风险预测模型 

分 类 号：R4[医药卫生—临床医学]