| 摘要: |
| 目的：探究彩色多普勒超声参数列线图模型在瘢痕妊娠(CSP)术中大出血风险中的预测价值。方法：回顾性分析了2017年9月至2021年9月在甘肃省妇幼保健院收治的254例经病理确诊的CSP患者的临床资料,根据清宫、宫/腹腔镜手术治疗时的出血量分为两组,其中研究组60例(出血量≥400ml),对照组194例(出血量<400ml)。比较两组患者临床及超声特征之间的差异。采用Logistic回归筛选CSP术中大出血的危险因素,然后构建列线图预测模型并通过校准图及ROC曲线对预测模型进行评估。结果：与对照组比较,研究组患者残余肌层厚度降低(P<0.05),病灶大小及腹痛、病灶类型为包块型、血流分级III级的发生率升高(P<0.05)。Logistic回归分析结果示,腹痛、病灶大小、残余肌层厚度、病灶类型、血流分级为CSP患者术中大出血的危险因素(P<0.05)。列线图校准曲线示,模型预测的大出血发生率与实际发生率具有较好的一致性,列线图预测模型的ROC曲线下面积AUC=0.878(95%CI：0.831-0.926,P<0.05)。结论：通过彩色多普勒参数构建的列线图预测模型对CSP患者术中大出血风险具有较好的预测价值。 |
| 关键词: 彩色多普勒超声 列线图 瘢痕妊娠 预测价值 |
| DOI： |
| 投稿时间：2021-10-13修订日期：2022-04-10 |
| 基金项目:甘肃省科技计划项目(项目编号：20JR5RA132) |
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| Predictive value of the nomogram model constructed by color Doppler ultrasound parameters in the risk of hemorrhage during scar pregnancy surgery |
| Ma Bin,Zhang Yanhua,Xu Xiaoyan,Wang Yixuan,Li Tiangang,Lu Yan |
| (Department of Functional Medicine,Maternal and Child Health Hospital of Gansu Province) |
| Abstract: |
| Objective: To explore the predictive value of the nomogram model constructed by color Doppler ultrasound parameters in the risk of hemorrhage during scar pregnancy (CSP) surgery. Methods: A retrospective analysis of the clinical data of 254 patients with pathologically confirmed CSP who were admitted to the Gansu Provincial Maternity and Child Health Hospital from September 2017 to September 2021. The patients were divided into two groups according to the bleeding volume during uterine cleaning and uterine/laparoscopic surgery, including 60 cases in the study group (bleeding volume ≥400ml) and 194 cases in the control group (bleeding volume <400ml). Compare the differences between the two groups of patients in clinical and ultrasound characteristics. Logistic regression was used to screen the risk factors of hemorrhage during CSP operation, and then a nomogram prediction model was constructed, and the prediction model was evaluated by calibration chart and ROC curve. Results: Compared with the control group, the thickness of the residual muscle layer of the patients in the study group was reduced (P<0.05), the size of the lesions and the incidence of the abdominal pain, the mass lesion type, and the grade III blood flow classification were increased (P<0.05). Logistic regression analysis showed that abdominal pain, lesion size, residual muscle thickness, lesion type, and blood flow classification were risk factors for intraoperative hemorrhage in CSP patients (P<0.05). The nomogram calibration curve shows that the incidence of hemorrhage predicted by the model was in good agreement with the actual incidence. The area under the ROC curve of the nomogram prediction model was AUC=0.878 (95%CI: 0.831-0.926, P<0.05). Conclusion: The nomogram prediction model constructed by color Doppler parameters has a good predictive value for the risk of intraoperative hemorrhage in CSP patients. |
| Key words: color Doppler ultrasound nomogram cesarean scar pregnancy predictive value |
