瘢痕子宫产前预测改良评分法的临床研究

发布时间：2018-11-05 15:43

【摘要】：目的:建立瘢痕子宫产前预测改良评分法,评估剖宫产后再次妊娠的患者阴道试产结局的风险。方法:参考《头位分娩评分法》及《bishop评分法》,建立瘢痕子宫产前预测改良评分法(简称改良评分法),绘制并与Weitein's法、Flamm法的ROC曲线下面积进行比较。根据改良评分法的ROC曲线得到最佳截断点,并以此分析改良评分法分值与试产结局的关系。结果:改良评分法的ROC曲线下面积(0.988)明显大于Weitein's法(0.577)和Flamm法(0.616),3种诊断效率的比较,差异有统计学意义(P0.05)。改良评分法的ROC曲线得到最佳截断点为18分,改良评分法评分18分的阴道分娩率(94.8%)高于评分≤18分(5.6%),差异有统计学意义(P0.05);阴道分娩组(93例)的评分(22.33±1.94分)明显高于剖宫产组(39例)的评分(14.35±1.87分),差异有统计学意义(P0.05)。结论:改良评分法的诊断效率较传统方法高,能较好评估剖宫产后再次妊娠阴道试产的结局。
[Abstract]:Objective: to establish an improved prenatal prediction score for scar uterus to assess the risk of vaginal trial delivery in patients with secondary pregnancy after cesarean section. Methods: referring to "cephalic delivery scoring method" and "bishop score method", an improved score method for prenatal prediction of scar uterus (improved score method) was established and compared with the area under ROC curve of Weitein's method and Flamm method. According to the ROC curve of the improved scoring method, the best cut-off point was obtained, and the relationship between the score of the improved scoring method and the outcome of trial production was analyzed. Results: the area under the ROC curve (0.988) of the improved scoring method was significantly larger than that of the Weitein's (0.577) and Flamm (0.616) methods, and the difference was statistically significant (P0.05). The best cut-off point of the ROC curve of the improved scoring method was 18 points. The vaginal delivery rate (94.8%) of the modified score of 18 points was higher than that of 鈮，

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