微创医学2026，Vol.21Issue(2)：191-196,6.DOI:10.11864/j.issn.1673.2026.02.09
上消化道病变患者内镜黏膜下剥离术术后穿孔的危险因素及风险预测模型
Risk factors and risk prediction model for perforation after endoscopic submocosal dissection in patients with upper gastrointestinal lesions
摘要
Abstract
Objective To investigate the risk factors for perforation after endoscopic submucosal dissection(ESD)in patients with upper gastrointestinal lesions and to construct a risk prediction model.Methods A retrospective analysis was conducted on the clinical data of 246 patients with upper gastrointestinal lesions who underwent ESD.Patients were divided into a perforation group(n=28)and a non-perforation group(n=218)according to the occurrence of postoperative perforation.Clinical data were compared between the two groups.Multivariate Logistic regression analysis was applied to identify the risk factors for perforation after ESD in patients with upper gastrointestinal lesions,and a risk prediction model was constructed based on these risk factors.The discrimination of the model was assessed using receiver operating characteristic(ROC)curves.Results Of 246 patients with upper gastrointestinal lesions who underwent ESD,28 developed perforation,with an incidence rate of 11.38%.The perforation group had significantly higher proportions of female patients,lesion diameter≥3 cm,postoperative malignant pathology,and operation duration≥60 min than the non-perforation group(P<0.05).The results of multivariate Logistic regression analysis showed that female,lesion diameter≥3 cm,malignant postoperative pathology,and operation duration≥60 min were independent risk factors for perforation after ESD in patients with upper gastrointestinal lesions(P<0.05).A risk prediction model for post-ESD perforation was established based on the results of multivariate Logistic regression analysis.The area under the curve was 0.826(95%CI:0.780,0.872),with a sensitivity of 0.679 and a specificity of 0.633,indicating that the model had favorable discrimination.Conclusion Female,lesion diameter≥3 cm,postoperative malignant pathology,and operation duration≥60 min are risk factors for perforation after ESD in patients with upper gastrointestinal lesions.The risk prediction model established based on the above risk factors has certain clinical application value.关键词
上消化道病变/内镜黏膜下剥离术/穿孔/危险因素/预测模型Key words
Upper gastrointestinal lesions/Endoscopic submucosal dissection/Perforation/Risk factors/Prediction model引用本文复制引用
谢榕,张伟伟,刘晓霞,黄钢丁,覃屹,王家旭,罗期,滕林华..上消化道病变患者内镜黏膜下剥离术术后穿孔的危险因素及风险预测模型[J].微创医学,2026,21(2):191-196,6.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z-A20250879) （编号:Z-A20250879）
