经口内镜下肌切开术的难度预测模型独立队列验证  

Prediction model for difficulty of peroral endoscopic myotomy:an independent cohort validation

作　　者：任依梦 刘歆阳 李全林 周平红 REN Yimeng;LIU Xinyang;LI Quanlin;ZHOU Pinghong(Endoscopy Center,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院内镜中心,上海200032

出　　处：《中国临床医学》2025年第2期283-287,共5页Chinese Journal of Clinical Medicine

基　　金：上海市“科技创新行动计划”启明星项目扬帆专项(22YF1424300)。

摘　　要：目的通过贲门失弛缓症独立队列验证经口内镜下肌切开术(peroral endoscopic myotomy,POEM)难度预测模型的预测效能。方法纳入2021年1月至2023年12月在复旦大学附属中山医院内镜中心接受POEM治疗的617例贲门失弛缓症患者。收集患者的一般资料,验证POEM难度预测模型预测手术风险的准确性,并进行分层分析。结果617例患者中,POEM技术困难90例(14.6%)。POEM难度预测模型预测验证队列手术难度的受试者工作特征曲线下面积(AUC)为0.711(95%CI 0.643~0.780)。根据该模型,将患者分为技术困难低危组(风险评分<0.1分)、中危组(0.1~0.25分)和高危组(风险评分≥0.25分),困难手术分别占7.3%、16.9%和51.6%。结论本中心构建的POEM难度预测模型的稳定性和区分度良好,临床应用价值较高。Objective To validate the efficacy of the prediction model for difficulty of peroral endoscopic myotomy(POEM)through an independent cohort.Methods A total of 617 patients with achalasia who underwent POEM at the Endoscopy Center of Zhongshan Hospital,Fudan University from January 2021 to December 2023 were included.The general data of patients were collected,and the predictive value of the prediction model for POEM difficulty in the validation cohort was estimated.The stratified analysis was undergone according to the difficulty risk scores.Results In 617 consecutive patients,technical difficulty was observed in 90 cases(14.6%).The predictive model demonstrated moderate discriminatory capacity with an area under the receiver operating characteristic curve(AUC)of 0.711(95%CI 0.643-0.780).Patients were stratified into three risk categories according to the difficulty risk scores:low-risk(<0.1),medium-risk(0.1-0.25),and high-risk(≥0.25).The corresponding technical difficulty rates were 7.3%,16.9%,and 51.6%,respectively.Conclusion The prediction model for POEM difficulty built by our center shows good stability and discrimination,and has good clinical application value.

关 键 词：贲门失弛缓症 经口内镜下肌切开术 预测模型验证 

分 类 号：R5712[医药卫生—消化系统]