| 孟冉,方政,沈迎丽,等.基于年龄与盆底量表的联合模型对子宫托长期使用的预测价值[J].中国临床保健杂志,2025,28(2):256-260. |
| 基于年龄与盆底量表的联合模型对子宫托长期使用的预测价值 |
| Predictive value of a combined model based on age and pelvic floor scale for long-term use of pessaries |
| 投稿时间：2024-09-17 |
| DOI：10.3969/J.issn.1672-6790.2025.02.022 |
| 中文关键词: 盆腔器官脱垂 子宫托 治疗依从性 年龄因素 预测 |
| 英文关键词: Pelvic organ prolapse Pessaries Treatment adherence and compliance Age factors Forecasting 〖FL |
| 基金项目:安徽省临床医学研究转化专项(202427b10024722)；安徽省重点研究与开发项目(202004j07020016) |
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| 中文摘要: |
| 目的 探讨年龄与盆底量表的联合模型对盆腔器官脱垂(POP)患者长期使用子宫托的预测价值。方法 回顾性分析2021年1月至2022年12月安徽医科大学附属省立医院收治的348例症状性POP患者临床资料。根据患者是否在1年后继续使用子宫托,将其分为继续使用组和停止使用组。收集基线数据,采用盆底不适调查表简表(PFDI-20)和盆底功能影响问卷简表(PFIQ-7)评估症状改善情况,通过二元logistic回归模型进行单因素及多因素分析,绘制受试者工作特征(ROC)曲线以评估模型的预测效能。结果 262例(75.29%)患者持续使用子宫托≥1年。2组在年龄、是否绝经、有无合并症、有无性生活、脱垂程度及量表评分方面比较,差异均有统计学意义(均P<0.05)。多因素分析表明,年龄(OR=0.95,AUC=0.668)、PFIQ-7改善＞50%(OR=0.21,AUC=0.687)及PFDI-20改善＞50%(OR=0.17,AUC=0.717)为继续使用的独立预测因素。联合模型显著提升预测效能(AUC=0.820)。症状缓解程度(PFDI-20评分改善＞50%、PFIQ-7评分改善＞50%)对长期依从性影响最显著。结论 年龄与盆底量表症状改善的联合模型可有效预测子宫托长期使用价值,较单一指标更具临床指导价值,为筛选长期获益患者提供客观依据。 |
| 英文摘要: |
| Objective To explore the predictive value of a combined model based on age and pelvic floor scales for the long-term use of pessaries in patients with pelvic organ prolapse (POP).Methods A retrospective analysis was conducted on clinical data from 348 symptomatic POP patients from Anhui Provincial Hospital Affiliated to Anhui Medical University between January 2021 and December 2022.Patients were divided into a continued-use group and a discontinued-use group based on whether they continued using pessaries after one year.Baseline data were collected,and symptom improvement was assessed using the Pelvic Floor Distress Inventory Short Form (PFDI-20) and the Pelvic Floor Impact Questionnaire Short Form (PFIQ-7).Univariate and multivariate analyses were performed using binary logistic regression.The predictive performance of the model was evaluated using the receiver operating characteristic (ROC) curve.Results A total of 262 patients (75.29%) continued using pessaries for ≥ 1 year.Significant differences were observed between the two groups in terms of age,menopausal status,comorbidities,sexual activity,degree of prolapse,and scale scores (P<0.05).Multivariate analysis identified age (OR=0.95,AUC=0.668),PFIQ-7 improvement> 50% (OR=0.21,AUC=0.687),and PFDI-20 improvement> 50% (OR=0.17,AUC=0.717) as independent predictors of continued use.The combined model significantly improved predictive performance (AUC=0.820).Symptom relief (PFDI-20 and PFIQ-7 improvement>50%) had the most significant impact on long-term adherence.Conclusions The combined model incorporating age and symptom improvement on pelvic floor scales can effectively predicts long-term pessary use,demonstrating greater clinical utility than individual indicators.It provides an objective basis for identifying patients likely to benefit from long-term pessary use. |
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