腹腔镜外科杂志2026，Vol.31Issue(7)：508-514,7.DOI:10.13499/j.cnki.fqjwkzz.2026.07.508
结直肠息肉内镜黏膜下剥离术后早期康复的影响因素分析及列线图预测模型构建
Analysis of influencing factors of early rehabilitation after endoscopic submucosal dissection for colorectal polyps and construction of nomogram prediction model
摘要
Abstract
Objective:To explore the influencing factors of early rehabilitation in patients after endoscopic submucosal dissec-tion(ESD)for colorectal polyps,and to construct a nomogram prediction model.Methods:A retrospective analysis was performed on clinical data of 400 patients with colorectal polyps treated with ESD from Jan.2023 to Jan.2026.The patients'age ranged from 48 to 68 years,with an average of(57.24±6.13)years.There were 240 males and 160 females.On the 3rd day after operation,the 15-item quality of recovery-15(QoR-15)scores of patients were recorded.According to the standard,patients were divided into the score＜118 group(n=85)and score≥118 group(n=315).Multivariate logistic regression model was used to analyze the influencing factors of pa-tients with QoR-15 score＜118.A nomogram prediction model was constructed based on the influencing factors,and the efficacy of the model was evaluated.Results:Univariate analysis results indicated that there were statistically significant differences in age,body mass index,maximum polyp diameter,anesthesia method,and implementation of enhanced recovery after surgery(ERAS)measures be-tween the two groups(P＜0.05).Multivariate logistic regression analysis results indicated that advanced age(OR=2.823),high body mass index(OR=4.056),large maximum polyp diameter(OR=5.500),general anesthesia(OR=4.162),and incomplete implementa-tion of enhanced recovery after surgery measures(OR=6.025)were influencing factors for the patients with QoR-15 score＜118(P＜0.05).Based on the influencing factors,a nomogram prediction model was constructed.The area under the receiver operating charac-teristic curve of the model was 0.875,and the calibration curve indicated good goodness of fit(χ2=3.522,P=0.773).Decision curve analysis indicated that the model had good clinical net benefit.Both internal and external validation results were ideal.Conclusions:The clarification of influencing factors for early rehabilitation and the construction of nomogram prediction model for patients after ESD can help medical and health institutions rapidly and accurately identify high-risk groups,so as to take targeted measures in a timely manner and promote early rehabilitation of patients.关键词
结直肠息肉/内镜黏膜下剥离术/康复/影响因素分析/列线图Key words
Colorectal polyp/Endoscopic submucosal dissection/Rehabilitation/Root cause analysis/Nomograms分类
医药卫生引用本文复制引用
吴莉,陈丽娟,吕桂芬,江丹帝,文丹,田龙..结直肠息肉内镜黏膜下剥离术后早期康复的影响因素分析及列线图预测模型构建[J].腹腔镜外科杂志,2026,31(7):508-514,7.基金项目
上海市科学技术重点研发计划项目(2400140) （2400140）
