中国内镜杂志2025，Vol.31Issue(7)：25-30,6.DOI:10.12235/E20240581
食管静脉曲张患者内镜诊疗过程中血栓头脱落出血的危险因素分析及风险预测模型构建
Analysis of risk factors of bleeding caused by thrombus head shedding in patients with esophageal varices during endoscopic diagnosis and treatment and construction of nomogram prediction model
王明辉 1刘晓峰 1李群 1王静 1李文波1
作者信息
- 1. 解放军联勤保障部队第九六〇医院 消化内科,山东 济南 250031
- 折叠
摘要
Abstract
Objective To investigate the risk factors of thrombus head shedding and bleeding during endoscopic treatment of patients with esophageal varices veins,and build a risk prediction model.Methods 209 cases of esophageal varices with thrombus head found by endoscopy from February 2009 to July 2024 were retrospectively analyzed,and divided into non-shedding group(n=186)and shedding group(n=23)according to whether thrombus head shedding bleeding occurred during endoscopic treatment.Clinical and endoscopic data of the two groups were compared.Statistically significant factors were included in multivariate Logistic regression analysis and their independent risk factors were explored.A nomogram risk prediction model was constructed by R software,and its prediction efficiency was evaluated.Results Multivariate Logistic regression analysis showed that red thrombus head((O＾R)=6.231,95%CI:1.748～22.208),thrombus head diameter≥3 mm((O＾R)=4.355,95%CI:1.341～14.144),conical thrombus head((O＾R)=8.555,95%CI:2.427～30.154),and the presence of hematoma in the stomach((O＾R)=7.079,95%CI:1.665～30.103)were risk factors for bleeding after thrombus head shedding during endoscopic diagnosis and treatment.A nomogram prediction model was constructed with a sensitivity of 0.870(95%CI:0.732～1.000)and a specificity of 0.887(95%CI:0.842～0.933).Conclusion The thrombus head being red,conical in shape,with a diameter of≥3 mm and the presence of hematoma in the stomach are independent risk factors for thrombus head shedding and bleeding during endoscopic diagnosis and treatment.Timely intervention should be made for the above factors to benefit patients.关键词
食管静脉曲张破裂出血(EVB)/血栓头/危险因素/列线图模型Key words
esophageal variceal bleeding(EVB)/thrombus head/risk factors/nomogram model分类
医药卫生引用本文复制引用
王明辉,刘晓峰,李群,王静,李文波..食管静脉曲张患者内镜诊疗过程中血栓头脱落出血的危险因素分析及风险预测模型构建[J].中国内镜杂志,2025,31(7):25-30,6.
