|
|
|
本文已被:浏览 463次 下载 569次 |
|
基于盆底超声参数构建的列线图模型预测盆底重建术后 进展性压力性尿失禁的价值 |
何丽英,张平洋 |
|
(皖南医学院第一附属弋矶山医院;南京医科大学附属南京医院(南京市第一医院)) |
|
摘要: |
目的 分析女性盆底盆底脏器脱垂(pop)患者进行盆底重建术后发生进展性尿失禁的危险因素,并构建其风险预测模型。方法 回顾2019年5月至2022年4月因ICS-POP Q评分≥II度盆底脏器脱垂患者,于皖南医学院弋矶山医院行盆底重建术6个月后发生新发或加重SUI患者进行分析,并收集及随访495例患者的一般临床资料,术前盆底超声检查结果。根据术前、术后SUI发生的情况,分为SUI改善组和进展组(包括新发和加重病例),采用单因素和多因素Logistic 回归分析,并建立术后进展性SUI的风险预测模型,并进行内部验证,使用R软件rms程序包构建其风险Nomogram图。结果 本次研究中有76例患者术后发生进展性SUI。术前指压诱发试验SUI阳性、POP-Q评分指示点Ba点位置低、盆底超声检查尿道内口小漏斗形成及肛提肌损伤史是术后发生进展性SUI的独立危险因素,联合以上四种参数构建模型Logit P,以0.515为截断值,该模型C-统计量为0.885(95%CI 0.737~0.936),约登指数为0.673,敏感度为0.936,特异性为0.737,阳性似然比为3.557,阴性似然比为0.087,诊断比之比为40.885,阳性预测值0.911,阴性预测值0.800。结论 本研究最终建立盆底重建术后发生进展性SUI的风险预测Nomogram图,预测效果佳,为POP患者术前治疗方案提供临床价值。 |
关键词: 盆底脏器脱垂 Logistic 回归 术后进展性SUI 风险预测Nomogran图 |
DOI: |
投稿时间:2022-12-04修订日期:2023-02-03 |
基金项目:南京市科技发展资助计划(医学项目);南京市医学发展重点项目(ZKX17026) |
|
Nomogram model of progressive stress urinary incontinence after pelvic floor reconstruction in women |
He liying,Zhang pingyang |
(Yijishan hospital, the First Affiliated Hospital of Wannan Medical College) |
Abstract: |
Objective To analyze the risk factors of progressive urinary incontinence in female patients with pelvic floor organ prolapse (pop) after pelvic floor reconstruction, and to construct its risk prediction model, so as to provide a clinical tool for predicting postoperative progressive SUI. Methods From May, 2019 to April, 2022, patients with pelvic floor organ prolapse with ICS-POP Q score ≥II, who underwent pelvic floor reconstruction in Yijishan Hospital of Wannan Medical College for 6 months, were retrospectively analyzed. The general clinical data and preoperative pelvic floor ultrasound results of 495 patients were collected and followed up. According to the occurrence of SUI before and after operation, it was divided into SUI improvement group and progressive group (including new and aggravated cases). Univariate and multivariate Logistic regression analysis was adopted, and the risk prediction model of progressive SUI after operation was established, and internal verification was carried out. R software rms package was used to construct its risk Nomogram. Results In this study, 76 patients developed progressive SUI after operation. Positive SUI in preoperative acupressure test, low position of Ba point indicated by POP-Q score, formation of small funnel in urethral orifice by pelvic floor ultrasound and levator ani avulsion are independent risk factors for postoperative progressive SUI. Combining the above four parameters, a model Logit P was established, with 0.515 as the cutoff value. The C- statistic of the model was 0.885(95%CI 0.737~0.936), and the Jordan index was 0.936. Sensitivity is 0.936, specificity is 0.737, positive likelihood ratio is 3.557, negative likelihood ratio is 0.087, diagnostic ratio is 40.885, positive predictive value is 0.911, negative predictive value is 0.800. Conclusion In this study, the Nomogram chart for predicting the risk of progressive SUI after pelvic floor reconstruction was finally established, which has a good prediction effect and provides clinical value for preoperative treatment of POP patients. |
Key words: pelvic floor organ prolapse Logistic regression Postoperative progressive SUI Risk forecast Nomogran diagram |
|
|
|
|
|