克罗恩病患者1年内手术风险预测工具：影像学严重指数（ISI）

发布时间：2018-06-07 22:26

  本文选题：克罗恩病 + 手术　； 参考：《浙江大学》2016年硕士论文

【摘要】：目的克罗恩病患者常需要接受手术治疗,如何甄别手术风险高的患者是临床难点。能准确预测克罗恩病患者手术风险的指标对临床工作有较高的指导价值。本文提出一种基于影像学检查的新的预测指数,并验证其在预测克罗恩病患者1年内手术风险的准确性。方法回顾性分析2013年1月至2015年1月在我院就诊的克罗恩病患者。患者随访至手术或至少1年。影像学严重指数(ISI)通过影像学检查结果计算得出,参考病变部位,长度,严重程度等相关因素。根据患者1年内是否手术分为手术组和非手术组,并比较两组间影像学严重指数的差异,验证其准确性。并且通过ROC曲线选择最佳临界点。结果307例患者入选本项研究,其中91例行手术治疗。手术组患者的影像学严重指数(52.5)明显高于非手术组患者(20.9)(p0.001)；根据影像学严重指数将患者进行三分类,随着影像学严重指数升高,患者手术率明显升高(2.9%,17.6%,和68.0%)(p0.001)。ROC曲线下方面积为0.885,临界点为35.25,敏感性为80.2%,特异性为83.8%。当患者影像学严重指数35.25时,其手术率明显升高(OR=18.99)。结论影像学严重指数是预测克罗恩病患者1年内手术风险的可靠指标。影像学严重指数35.25的克罗恩病患者1年内的手术率较高,此部分病人需要密切随访或升阶梯治疗。
[Abstract]:Objective to identify the patients with Crohn's disease and how to identify the patients with high risk of surgery. It is of high value for clinical work to predict the risk of surgery for Crohn's disease. A new prediction index based on imaging examination is presented in this paper, and it is proved to be in the prediction of 1 of the patients with Crohn's disease. The accuracy of surgical risk during the year. Methods a retrospective analysis of the patients with Crohn's disease in our hospital from January 2013 to January 2015. Patients were followed up to surgery or at least 1 years. The imaging severity index (ISI) was calculated by imaging findings, referring to the related factors, such as lesion location, length, severity, and other factors. According to the patient's hand within 1 years. The operation group was divided into the operation group and the non operation group, and the difference between the two groups was compared and the accuracy was verified. And the best critical point was selected by the ROC curve. Results 307 patients were selected for this study, of which 91 cases were operated on. The imaging severity index (52.5) of the patients in the operation group was significantly higher than that of the non operative group (20.9) (p0.001). According to the imaging severity index, the patients were divided into three categories. With the increase of the imaging severity index, the operative rate of the patients increased significantly (2.9%, 17.6%, and 68%) (p0.001).ROC curve under the area of 0.885, the critical point 35.25, the sensitivity of 80.2%, and the specificity of 83.8%. when the patient's imaging severity index was 35.25 (OR=18 .99) conclusion the imaging severity index is a reliable index for predicting the risk of surgery within 1 years of Crohn's disease. The surgical rate of Crohn's disease in 35.25 of the imaging severity index is higher in 1 years, and this part of the patients needs close follow-up or step up treatment.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R656

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