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食道静脉直径与内镜静脉结合后早期再出血之间的相关性:基于人工智能内镜虚拟规则的多中心回顾性研究

Chuankun Cao^1,2, Jing Jin¹, Rui Cai²

¹Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Anhui Provincial Key Laboratory of Digestive Diseases, Hefei, China.

Frontiers in medicine

|June 27, 2024

概括

食道静脉 (EV) 的直径是内镜静脉结合 (EVL) 后再出血的关键预测因素. 1.4厘米或更大的EV直径表明高风险,建议在这种情况下谨慎使用EVL.

科学领域:

胃肠病学胃肠病学
医疗成像医学成像
人工智能的人工智能

背景情况:

经过内镜性水绑定 (EVL) 后的出血是一个重大问题,通常与很难完全绑定的大食道水 (EV) 有关.
精确测量EV直径对于选择适合EVL的候选者和最大限度地减少再出血风险至关重要.

研究的目的:

开发和验证基于人工智能的内镜虚拟统治器 (EVR),用于精确测量EV直径.
确定EV直径作为EVL后早期再出血的预测因素.

主要方法:

一项多中心回顾性研究,涉及727名肝硬化患者的1,062次EVL手术.
根据EVL后6周内出血的情况,患者被分为早期复出血 (n=80) 和非复出血 (n=982) 组.
使用后勤回归和ROC分析来评估风险因素,包括EV直径.

主要成果:

早期再出血率为7.5%,出血后6周死亡率为16.5%.
多因素分析确定了Child-Pugh等级C,日本水等级F3和EV直径作为早期再出血的重要预测因素.
与日本水等级 (AUC=0.635) 相比,EV直径显示出更高的预测值 (AUC=0.848).
截止EV直径为1.35厘米,预测了早期复出,灵敏度为70.0%,特异性为89.2%.

结论:

食道水直径是EVL后早期再出血的更优的预测因素,而不是目前的日本水分级.
EV直径≥1.4厘米表明早期再出血的风险很高,因此在这些患者中需要谨慎使用EVL.

关键词:

人工智能的人工智能是人工智能.早期重新出血早期的重新出血透镜内性水绑定透镜内性水绑定消化道的水.肝硬化是肝硬化的一种疾病.门高血压门高血压结合后的.

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