摘要
目的:基于多模态超声参数、临床特征分析早孕期瘢痕妊娠清宫术中出血风险的影响因素。方法:回顾性选取2021年8月—2024年8月我院收治的82例早孕期瘢痕妊娠患者,均接受清宫术治疗,根据术中出血情况(是否超过100 m L)将患者分为少量出血组和出血组。比较两组临床资料、多模态超声指标,通过多因素Logistic回归分析早孕期瘢痕妊娠清宫术中出血的危险因素。结果:多因素Logistic回归分析结果显示,孕囊大小、前峡部绒毛膜厚度、血管形成指数、曲线下面积为早孕期瘢痕妊娠清宫术中出血的危险因素(P<0.05)。将上述因素纳入回归方程:logit(P)=-7.833+孕囊大小×0.753+前峡部绒毛膜厚度×0.567+血管形成指数×0.699+曲线下面积×0.864。按照诊断概率logit(P)绘制预测早孕期瘢痕妊娠清宫术中出血的ROC曲线,当logit(P)>11.82时,曲线下面积为0.917。结论:早孕期瘢痕妊娠清宫术中出血受孕囊大小、前峡部绒毛膜厚度、血管形成指数、曲线下面积等影响,基于多模态超声参数的Logistic回归方程在预测早孕期瘢痕妊娠清宫术中出血的风险中有一定价值。
Objective:To analyze the factors affecting the risk of hemorrhage during the curettage in early pregnancy based on multi-modal ultrasound parameters and clinical characteristics.Methods:A total of 82 patients with cesarean scar pregnancy in our hospital from August 2021 to August 2024 were retrospectively enrolled.All patients underwent curettage.According to the amount of intraoperative bleeding(=100 mL or>100 mL),the patients were divided into a mild bleeding group and a bleeding group.The clinical data and multimodal ultrasound parameters were compared between the two groups.Multivariate Logistic regression analysis was performed to identify the risk factors for intraoperative hemorrhage during curettage in early cesarean scar pregnancy.Results:Multivariate Logistic analysis showed that gestational sac size,anterior isthmic chorionic thickness,vascularization index,and area under the curve were independent risk factors for intraoperative hemorrhage during curettage in early cesarean scar pregnancy(P<0.05).The regression equation was as follows:logit(P)=-7.833+gestational sac size×0.753+anterior isthmic chorionic thickness×0.567+vascularization indexx0.699+area under the curve×0.864.Based on the diagnostic probability logit(P),the ROC curve for predicting intraoperative hemorrhage was plotted.When logit(P)>11.82,the area under the curve was O.917.Conclusion:Intraoperative hemorrhage during curettage for cesarean scar pregnancy in early pregnancy is influenced by multimodal ultrasound parameters such as gestational sac size,anterior isthmic chorionic thickness,vascularization index,and area under the curve.The Logistic regression model based on multimodal ultrasound parameters has potential value in predicting the risk of intraoperative hemorrhage in early cesarean scar pregnancy.
作者
霍丽娜
李燕玮
张慧
吴群
葛庆玲
周长江
HUO Li-na;LI Yan-wei;ZHANG Hui;WU Qun;GE Qing-ling;ZHOU Chang-jiang(Department of Ultrasound,Affiliated People's Hospital of Shandong First Medical University,Jinan 271100,China)
出处
《中国临床医学影像杂志》
北大核心
2025年第12期886-889,共4页
Journal of China Clinic Medical Imaging
基金
山东省科技发展计划项目(LKJGG2021W056)。
关键词
妊娠
异位
超声检查
Pregnancy,Ectopic
Ultrasonography
