本文選題：克羅恩病 + 手術(shù)　； 參考：《浙江大學》2016年碩士論文

【摘要】：目的克羅恩病患者常需要接受手術(shù)治療,如何甄別手術(shù)風險高的患者是臨床難點。能準確預測克羅恩病患者手術(shù)風險的指標對臨床工作有較高的指導價值。本文提出一種基于影像學檢查的新的預測指數(shù),并驗證其在預測克羅恩病患者1年內(nèi)手術(shù)風險的準確性。方法回顧性分析2013年1月至2015年1月在我院就診的克羅恩病患者�；颊唠S訪至手術(shù)或至少1年。影像學嚴重指數(shù)(ISI)通過影像學檢查結(jié)果計算得出,參考病變部位,長度,嚴重程度等相關(guān)因素。根據(jù)患者1年內(nèi)是否手術(shù)分為手術(shù)組和非手術(shù)組,并比較兩組間影像學嚴重指數(shù)的差異,驗證其準確性。并且通過ROC曲線選擇最佳臨界點。結(jié)果307例患者入選本項研究,其中91例行手術(shù)治療。手術(shù)組患者的影像學嚴重指數(shù)(52.5)明顯高于非手術(shù)組患者(20.9)(p0.001)；根據(jù)影像學嚴重指數(shù)將患者進行三分類,隨著影像學嚴重指數(shù)升高,患者手術(shù)率明顯升高(2.9%,17.6%,和68.0%)(p0.001)。ROC曲線下方面積為0.885,臨界點為35.25,敏感性為80.2%,特異性為83.8%。當患者影像學嚴重指數(shù)35.25時,其手術(shù)率明顯升高(OR=18.99)。結(jié)論影像學嚴重指數(shù)是預測克羅恩病患者1年內(nèi)手術(shù)風險的可靠指標。影像學嚴重指數(shù)35.25的克羅恩病患者1年內(nèi)的手術(shù)率較高,此部分病人需要密切隨訪或升階梯治療。
[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.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R656

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本文編號：1993033