宫腔镜治疗子宫憩室疗效及其影响因素的Logistic回归分析

doi:10.3969/j.issn.1007-3205.2023.03.010

摘要/Abstract

摘要： 目的探讨宫腔镜治疗子宫憩室疗效，并采用Logistic回归分析其疗效的相关影响因素。
方法选取子宫憩室患者80例，均给予宫腔镜治疗，统计治疗效果，并根据治疗效果将患者分为憩室未消失组（n=24）、消失组（n=56），采用多因素Logistic回归分析宫腔镜治疗子宫憩室疗效的相关影响因素，采用受试者工作特征曲线（receiver operating characteristic，ROC）分析各影响因素及所构建的Logistic回归方程预测疗效价值。
结果 80例子宫憩室患者，均顺利成功实施宫腔镜手术，术后无感染、器官出血等并发症发生，70.00%（56/80）患者术后憩室消失，30.00%（24/80）患者憩室仍存在，但较术前明显减小，所有患者行经期均不同程度缩短；未消失组剖宫产次数多于消失组，憩室深度高于消失组，残余肌层厚度低于消失组（P＜0.05）；剖宫产次数、憩室深度是疗效相关危险因素，残余肌层厚度是疗效相关保护因素（P＜0.05），Logit（P）=-5.296+3.129×剖宫产次数+2.857×憩室深度-0.920×残余肌层厚度；与单独的各相关因素比较，所构建的Logistic回归方程预测疗效的ROC下面积（area under the curve，AUC）最大。
结论宫腔镜手术能促进子宫憩室消失，改善患者临床症状，其术后疗效受患者剖宫产次数、憩室深度、残余肌层厚度影响，术前评估以上三因素，可为临床手术方式抉择提供客观量化参考，既能最大程度保证治疗效果，又避免过度治疗。

关键词: 宫腔镜检查, 憩室, 治疗结果, 影响因素分析

Abstract: Objective To investigate the efficacy of hysteroscopic treatment of uterine diverticulum, and to analyze the factors influencing its efficacy using logistic regression analysis.
Methods Eighty patients with uterine diverticulum were selected and given hysteroscopic treatment, and the therapeutic effects were recorded. The patients were divided into non-disappearance of uterine diverticulum group (non-disappearance group, n=24) and disappearance of uterine diverticulum group (disappearance group, n=56) according to the therapeutic effects. The influencing factors related to the efficacy of hysteroscopic treatment of uterine diverticulum were analyzed by multivariate logistic regression, and the receiver operating characteristic (ROC) curve was used to analyze the influencing factors and the constructed logistic regression equation was used to predict the value of efficacy.
Results Eighty patients with uterine diverticulum received hysteroscopic surgery successfully without complications such as infection and organ bleeding. 70.00% (56/80) patients had disappearance of uterine diverticulum after surgery, 30.00% (24/80) patients had uterine diverticulum that still existed but were significantly smaller than that before surgery, and all patients shortened their menstrual period to different degrees. The number of cesarean section was higher in the non-disappearance group than in the disappearance group, the depth of uterinediverticulum was higher than that in the disappearance group, and the thickness of residual myometrium was lower than that in the disappearance group (P＜0.05). The number of cesarean section and the depth of uterine diverticulum were the risk factors related to efficacy, and the thickness of residual myometrium was the protective factor related to efficacy (P＜0.05). Logit (P)=-5.296 + 3.129×number of cesarean section +2.857×depth of diverticulum -0.920 thickness of residual myometrium.Compared with each related factor alone, the constructed logistic regression equation had the largest area under the ROC curve (AUC) for predicting efficacy.
Conclusion Hysteroscopic surgery can promote the disappearance of uterine diverticulum and improve patients' clinical symptoms. Its postoperative efficacy is influenced by the number of cesarean sections, the depth of the diverticulum, and the thickness of residual myometrium. Therefore, the preoperative assessment of these three factors can provide objective quantitative reference for the choice of clinical surgical modality, which can ensure the maximum therapeutic effect while avoiding overtreatment.

Key words: hysteroscopy, diverticulum, treatment outcome, influencing factor analysis

夏勤俭, 黄森, 陈丽琴. 宫腔镜治疗子宫憩室疗效及其影响因素的Logistic回归分析 [J]. 河北医科大学学报, 2023, 44(3): 295-299.

XIA Qin-jian, HUANG Sen, CHEN Li-qin. Logistic regression analysis of the efficacy of hysteroscopic treatment of uterine diverticulum and its influencing factors [J]. Journal of Hebei Medical University, 2023, 44(3): 295-299.

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宫腔镜治疗子宫憩室疗效及其影响因素的Logistic回归分析

Logistic regression analysis of the efficacy of hysteroscopic treatment of uterine diverticulum and its influencing factors

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