腹腔镜卵巢子宫内膜异位症保守性手术后复发的危险因素分析及风险预警模型建立

丁霞; 邓懿阳; 银萍; 陈晓宇

doi:10.13898/j.cnki.issn.1000-2200.2022.09.031

腹腔镜卵巢子宫内膜异位症保守性手术后复发的危险因素分析及风险预警模型建立

Analysis of risk factors for recurrence of laparoscopic ovarian endometriosis after conservative surgery and establishment of a risk early warning model

摘要

摘要:
目的筛选腹腔镜卵巢子宫内膜异位症(OEM)保守性手术后复发的危险因素，并建立相关风险预警模型。
方法收集因OEM行腹腔镜保守性手术治疗病人174例临床资料，采用单因素和logistic回归多因素分析，对影响腹腔镜OEM保守性手术后复发的相关因素进行分析，并建立列线图预测模型。
结果年龄小、术前痛经史、既往药物治疗史、后穹隆触痛、r-AFS分期高、双侧病变和术后未用药均为腹腔镜OEM保守性手术后复发的独立危险因素(P<0.05~P<0.01)。依此建立相关列线图模型，并对该模型进行验证，结果显示，C-index为0.817，校正曲线和理想曲线拟合反映较好，AUC为0.839(95%CI 0.802~0.874)，表明该模型具有良好的预测能力。
结论基于危险因素建立的列线图模型对早期评估腹腔镜OEM保守性手术后复发风险具有良好的预测能力。

Abstract:
ObjectiveTo screen the risk factors of recurrence after laparoscopic conservative surgery for ovarian endometriosis (OEM) and establish the related risk early warning model.
MethodsThe clinical data of 174 patients with OEM who underwent laparoscopic conservative surgery were collected.The related factors affecting the recurrence after laparoscopic OEM conservative surgery were analyzed by univariate and multivariate logistic regression, and the nomogram prediction model was established.
ResultsYoung age, history of preoperative dysmenorrhea, history of previous medical treatment, posterior fornix tenderness, high r-AFS stage, bilateral lesions, and postoperative no medication were independent risk factors for recurrence after laparoscopic OEM conservative surgery (P<0.05 to P<0.01).A related nomogram model was established based on this, and the model was verified.The results showed that the C-index was 0.817, the calibration curve and the ideal curve fitted well, and the AUC was 0.839 (95%CI: 0.802-0.874), indicating the model had good predictive ability.
ConclusionsNomogram model based on risk factors has excellent prediction ability, which is of great clinical significance for early evaluation of recurrence risk after laparoscopic OEM conservative surgery.

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