超声联合腹壁瘢痕评分与再次剖宫产术中孕妇腹腔粘连的相关性分析  

Correlation analysis of ultrasound combined with abdominal wall scar score and abdominal adhesion in pregnant women during repeat cesarean section

作　　者：唐荣 吴清 邓婷 张宗芬 TANG Rong;WU Qing;DENG Ting;ZHANG Zongfen(Department of Ultrasound Medicine,West China Guang'an Hospital,Sichuan University,Guang'an Sichuan 638000,China)

机构地区：[1]四川大学华西广安医院超声医学科,四川广安638000

出　　处：《中国妇产科临床杂志》2024年第3期216-219,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：四川省基金项目-广安市科技创新指导性计划项目(2021zdxjh13)。

摘　　要：目的分析超声联合腹壁瘢痕评分与再次剖宫产术中孕妇腹腔粘连的相关性。方法选取2020年1月至2022年12月于四川大学华西广安医院住院行再次剖宫产术分娩的孕妇270例,其中185例出现无/轻度腹腔粘连(无/轻度粘连组),85例出现中/重度腹腔粘连(中/重度粘连组)。本文应用超声检测,计算超声滑动距离,并采用曼彻斯特瘢痕量表(MSS)对腹壁瘢痕进行评分,采用Logistic回归分析再次剖宫产术中孕妇腹腔粘连的危险因素,根据风险值确定回归模型,采用ROC曲线分析该模型预测再次剖宫产术中孕妇腹腔粘连的价值。结果中/重度粘连组MSS量表中外观、轮廓、变形和质地评分及MSS总分高于无/轻度粘连组(P<0.05),两组颜色评分比较差异无统计学意义(P>0.05);中/重度粘连组超声滑动距离短于无/轻度粘连组(P<0.05)。Logistic多因素回归分析显示,腹壁瘢痕外观、轮廓、质地为再次剖宫产术中腹腔粘连的危险因素,超声滑动距离为保护因素(P<0.05)。将单因素中P<0.05指标进行建模,计算预测概率,绘制ROC曲线,曲线下面积(AUC)为0.908,灵敏度为85.00%,特异度为90.00%,提示预测模型对预测再次剖宫产术中腹腔粘连预测准确性高。结论超声滑动距离和腹壁瘢痕评分是再次剖宫产术中腹腔粘连的影响因素,且超声联合腹壁瘢痕评分预测再次剖宫产术中腹腔粘连的价值高。Objective To analyze the correlation between ultrasound combined with abdominal wall scar score and abdominal adhesion in pregnant women during repeat cesarean section.Methods A total of 270 pregnant women who underwent repeat cesarean section in West China Guang'an Hospital of Sichuan University from January 2020 to December 2022 were selected,including 185 women without or with mild abdominal adhesion(no/mild adhesion group)and 85women moderate/severe abdominal adhesion(moderate/severe adhesion group).They were examined with ultrasound and the ultrasonic sliding distance was calculated.The Manchester Scar Scale(MSS)was used to score abdominal wall scars.Logistic regression analysis was performed to screen the risk factors for abdominal adhesion in pregnant women during repeat cesarean section,and the regression model was determined according to the risk value.The ROC curve was used to analyze the value of this model in predicting abdominal adhesion in pregnant women during repeat cesarean section.Results The scores for appearance,contour,deformation and texture,and the total MSS score in moderate/severe adhesion group were higher than those in no/mild adhesion group(P<0.05),but there was no significant difference in color scores between the two groups(P>0.05).The ultrasonic sliding distance in moderate/severe adhesion group was shorter than that in no/mild adhesion group(P<0.05).Logistic multivariate regression analysis showed that the appearance,contour and texture of abdominal wall scar were risk factors for abdominal adhesion during repeat cesarean section,and the ultrasonic sliding distance was a protective factor(P<0.05).A model was condtructed based on the factors with statistically significant differences in univariate analysis,the prediction probability was calculated,and the ROC curve was drawn.The area under the curve(AUC),sensitivity and specificity were 0.908,85.00%and 90.00%,indicating that the prediction model had high accuracy for predicting abdominal adhesion during repeat cesarean section.Concl

关 键 词：腹腔粘连 再次剖宫产 超声 腹壁瘢痕评分 相关性 

分 类 号：R719.8[医药卫生—妇产科学]