目的：探讨间歇性外斜视(IXT)术后立体视功能重建的影响因素及其列线图预测模型构建。

方法：选取本院2021年9月至2023年10月收治的IXT患者204例(均进行斜视矫正手术)，随机分为建模组(143例)与验证组(61例)。建模组患者根据术后是否立体视功能重建分为重建组和非重建组； 收集患者一般资料； IXT术后立体视功能重建的影响因素采用多因素Logistic回归分析； 采用R软件构建列线图模型。绘制ROC曲线评估列线图模型的区分度； 临床决策曲线(DCA)评估该模型的临床应用价值。

结果：患者204例中有103例(50.5%)发生重建，建模组143例中有72例(50.3%)发生重建。重建组和非重建组发病年龄、病程、术后水平斜视量比较有差异(均P<0.05)。多因素Logistic回归分析发现，发病年龄、术后水平斜视量是IXT术后立体视功能重建的危险因素(均P<0.05)，病程为保护因素(P<0.05)。建模组AUC为0.892，H-L检验为χ²=6.654，P=0.615。验证组AUC为0.935，H-L检验为χ²=6.498，P=0.642。DCA曲线可知，概率在0.09-0.95时，评估该列线图模型临床使用价值较高。

结论：发病年龄、病程、术后水平斜视量是IXT术后立体视功能重建的影响因素，以此构建的列线图模型可较好地预测术后立体视功能重建。

METHODS:A total of 204 patients with IXT(all underwent strabismus correction surgery)admitted to our hospital from September 2021 to October 2023 were randomly divided into modeling group(143 cases)and validation group(61 cases). The patients in the modeling group were further divided into reconstructive group and non-reconstructive group according to whether they had stereoscopic function reconstruction after surgery; the general patient information was collected; Multivariate Logistic regression analysis was performed on the influencing factors of stereoscopic visual function reconstruction after IXT surgery. The nomogram model was constructed using R software. The ROC curve was drawn to evaluate the distinction of the nomogram model. The decision curve analysis(DCA)was used to evaluate the clinical application value of the model.

RESULTS:Reconstruction occurred in 50.5%(103 cases)of the 204 patients, and reconstruction occurred in 50.3%(72 cases)of the 143 patients in the modeling group. There were differences in age of onset, course of disease and postoperative horizontal strabismus between the reconstructive group and the non-reconstructive group(all P<0.05). Multivariate Logistic regression analysis showed that age of onset and postoperative horizontal strabismus were risk factors for stereoscopic visual function reconstruction after IXT surgery(all P<0.05), and the course of disease was a protective factor(P<0.05). The AUC of the modeling group was 0.892, and the H-L test was χ²=6.654 and P=0.615. The AUC of the validation group was 0.935, and the H-L test was χ²=6.498 and P=0.642. The DCA curve showed that the clinical value of the nomogram model was higher when the probability was 0.09-0.95.

CONCLUSION: The age of onset, course of disease and postoperative amount of horizontal strabismus are the influencing factors of stereoscopic visual function reconstruction after IXT surgery, and the nomogram model constructed by this can better predict postoperative stereoscopic function reconstruction.