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基于经会阴超声的子宫脱垂诊断预测模型。

Predictive Model for the Diagnosis of Uterine Prolapse Based on Transperineal Ultrasound.

机构信息

Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain.

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Seville, 41009 Seville, Spain.

出版信息

Tomography. 2022 Jul 1;8(4):1716-1725. doi: 10.3390/tomography8040144.

Abstract

We want to describe a model that allows the use of transperineal ultrasound to define the probability of experiencing uterine prolapse (UP). This was a prospective observational study involving 107 patients with UP or cervical elongation (CE) without UP. The ultrasound study was performed using transperineal ultrasound and evaluated the differences in the pubis−uterine fundus distance at rest and with the Valsalva maneuver. We generated different multivariate binary logistic regression models using nonautomated methods to predict UP, including the difference in the pubis−uterine fundus distance at rest and with the Valsalva maneuver. The parameters were added progressively according to their simplicity of use and their predictive capacity for identifying UP. We used two binary logistic regression models to predict UP. Model 1 was based on the difference in the pubis−uterine fundus distance at rest and with the Valsalva maneuver and the age of the patient [AUC: 0.967 (95% CI, 0.939−0.995; p < 0.0005)]. Model 2 used the difference in the pubis−uterine fundus distance at rest and with the Valsalva maneuver, age, avulsion and ballooning (AUC: 0.971 (95% CI, 0.945−0.997; p < 0.0005)). In conclusion, the model based on the difference in the pubis−uterine fundus distance at rest and with the Valsalva maneuver and the age of the patient could predict 96.7% of patients with UP.

摘要

我们旨在描述一种模型,该模型可通过经会阴超声来定义发生子宫脱垂(UP)的概率。这是一项前瞻性观察性研究,共纳入 107 例 UP 或无 UP 的宫颈延长(CE)患者。超声检查通过经会阴超声进行,并评估静息状态和 Valsalva 动作时耻骨-子宫底距离的差异。我们使用非自动化方法生成了不同的多元二分类逻辑回归模型,以预测 UP,包括静息状态和 Valsalva 动作时耻骨-子宫底距离的差异。参数是根据其使用的简便性及其识别 UP 的预测能力逐步添加的。我们使用了两个二分类逻辑回归模型来预测 UP。模型 1 基于静息状态和 Valsalva 动作时耻骨-子宫底距离的差异以及患者年龄 [AUC:0.967(95%CI,0.939-0.995;p<0.0005)]。模型 2 使用静息状态和 Valsalva 动作时耻骨-子宫底距离的差异、年龄、撕脱和气球样变(AUC:0.971(95%CI,0.945-0.997;p<0.0005)]。总之,基于静息状态和 Valsalva 动作时耻骨-子宫底距离的差异以及患者年龄的模型可以预测 96.7%的 UP 患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44c6/9326672/1cb26479f5b3/tomography-08-00144-g001.jpg

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