摘要
目的:分析子宫输卵管造影(HSG)时受检者疼痛影响因素并构建回归预测模型。方法:回顾性纳入2023年2月-2024年6月于本院放射科行HSG检查的154例不孕症患者临床资料,依据检查过程中是否发生中重度疼痛分为疼痛组、非疼痛组,收集比较患者一般资料、疾病史、不孕情况、造影检查资料、焦虑症状等,采用二元logistic回归分析HSG受检者中重度疼痛的影响因素,构建回归预测模型,受试者操作特征(ROC)曲线评价模型预测效能,Bootstrap自助法获得C指数进行内部验证,H-L检验评价模型拟合度。结果:154例HSG检查过程中发生中重度疼痛42例,发生率为27.3%。疼痛组子宫腺肌病、子宫内膜息肉、输卵管双侧阻塞、高造影剂推注压力、造影剂逆流、中重度焦虑症状占比高于非疼痛组,造影剂温度为预加热占比低于非疼痛组(均P<0.05)。二元logistic回归分析显示,输卵管双侧阻塞、造影剂逆流、中重度焦虑症状为HSG受检者检查过程中发生中重度疼痛的危险因素,造影剂温度为预加热是保护因素(均P<0.05)。ROC曲线显示,回归预测模型预测HSG受检者检查过程中发生中重度疼痛的曲线下面积为0.887,Bootstrap法内部验证C指数为0.886。H-L检验显示χ^(2)=4.626,P>0.05。结论:HSG受检者检查过程中发生中重度疼痛的影响因素包括输卵管阻塞、造影剂温度、造影剂逆流、焦虑症状,且据此构建的模型预测价值良好。
Objective:To analyze the influence factors for the pain of the infertility patients during hystcrosalpingography(HSG)examination,and to build the regression prediction model for the pain of the patients.Methods:A retro-spective study was conducted on the clinical data of 154 infertile patients who underwent HSG examination in the hospital from February 2023 to June 2024.These patients were divided into group A(patients with moderate-to-severe pain during HSG examination)and group B(patients without pain during HSG examination).The general information,the disease history,the infertility status,the contrast examination data,the anxiety symptoms and the other clinical data of the women were collected and were compared between the two groups.Binary logistic regression analysis was used to analyze the influence factors of the modcratc-to-scvcre pain of the patients during the HSG examination and a regression prediction model was constructed according to these influence factors.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model for the modcratc-to-scvcre pain of the patients during HSG examination.The C-indcx was obtained by Bootstrap method for the internal validation,and the H-L test was used to evaluate the goodness of fit of the model.Results-There were 42 cases with the moderate to severe pain during HSG examination,with an incidence of 27.3%.The proportions of the adenomyosis,the endometrial polyps,the bilateral fallopian tube obstruction,the high contrast agent injection pressure,the contrast agent reflux and the moderate to severe anxiety symptoms of the patients in group A were significantly higher than those of the patients in group B.The proportion of the preheated contrast medium temperature of the patients in group A was significantly lower than that of the patients in group B(all P<0.05).Binary logistic regression analysis showed that the bilateral fallopian tube obstruction,the contrast medium reflux and the moderate to severe anxiety symptoms of the patients were the risk factors for their moderate to severe pain during the HSG examination,and the preheating of the contrast medium temperature of the patients was a protective factor(all P<0.05).ROC curve showed that the area under the curve of the regression prediction modtl for predicting the moderate to severe pain of the patients during the HSG examination was 0.887,the C index of Bootstrap method was 0.886.H-L test showed χ^(2)=4.626,P>0.05.Conclusion:The influence factors of the modcratc_to_scvcre pain of the patients during HSG examination include the tubal blockage,the contrast medium temperature,the contrast medium reflux and the anxiety symptoms,and the mode con-structed based on these factors of the patients has good predictive value for their pian occurrence during the HSG examnation.
作者
戚健
石丽莉
汪俊红
QI Jian;SHI Lili;WANG Junhong(Tangshan Maternal and Child Health Care Hospital,Tangshan,Hubei Province,063003)
出处
《中国计划生育学杂志》
2025年第7期1621-1625,1630,共6页
Chinese Journal of Family Planning
关键词
不孕症
子宫输卵管造影
中重度疼痛
影响因素
预测模型
Infertility
Hystcrosalpingography
Modcratc-to-scvcre pain
Risk factor
Prediction model
