超声预测卵巢过度刺激综合征患者腹腔积液量模型的建立及验证

Ultrasound forecast model of ascites volume in patients with ovarian hyperstimulation syndrome:Establishment and validation

目的通过超声测量卵巢过度刺激综合征(OHSS)患者腹盆腔6个部位(子宫前方、子宫直肠窝、右侧髂窝、左侧髂窝、肝肾隐窝、脾肾隐窝)腹腔积液深度,建立腹腔积液量预测模型并进行临床验证。方法选取经超声测量腹盆腔6个部位的腹腔积液体积并于测量6h内实施经阴道腹腔积液穿刺引流术的患者50例作为测算组,分别绘制引流腹腔积液量(Y;ml)与腹腔积液深度和(X;mm)、身高相关腹腔积液系数、体表面积相关腹腔积液系数的散点图,建立3个回归方程。采用相关性较好且更简单、实用回归方程为拟验证公式,追踪100例患者作为验证组,根据上述回归方程获得预测腹腔积液量,将其与实际引流腹腔积液量进行Bland-Altman一致性分析和配对t检验。结果测算组X与Y的直线回归方程为Y=-256.554+10.452 X(R^2=0.577),相关性较好且更简单,并简化为Y=10.5 X-250.0。验证组推测腹腔积液量与实际腹腔积液量的一致性界限为(-1 314.02,1 560.48)ml,偏倚为123.23 ml,且两者比较差异无统计学意义(t=-1.684,P=0.096)。结论可采用简化公式Y=10.5 X-250.0预测OHSS患者的腹腔积液量,指导临床工作。

Objective To establish and validate the ascites volume forecast model of ascites puncture drainage operation with ultrasound measuring for 6 positions in patients with ovarian hyperstimulation syndrome（OHSS）,including front of the uterus,Douglas pouch,right iliac fossa,left iliac fossa,hepatorenal recess and spleen kidney fossa.Methods Fifty patients received ultrasonographic measurement（measurement group）and then underwent ascites puncture drainage operation within 6 h.Three scatter diagrams of actual ascites volume（Y;ml）and key position ascites depth summation（X;mm）,height correlation coefficient and surface area correlation coefficient were drawn.The simple and practical regression equation with better correlation was used to be the one verified.Then 100 subsequently HSS patients were enrolled in verification group.Forecast ascites volume calculated with above-mentioned regression equation and actual ascites volume was analyzed with Bland-Altman method and paired t test.Results Regression equation obtained with the scatter diagram was Y=-256.554＋10.452 X（R^2=0.577）,which could be simplified as Y=10.5 X-250.0.The limit of consistency between forecast ascites volume and actual ascites volume was（-1 314.02,1 560.48）ml,and the bias was 123.23 ml.The difference between forecast ascites volume and actual ascites volume was not statistically significant（t=-1.684,P=0.096）.Conclusion The simplified equation is Y=10.5 X-250.0 to forecast ascites volume caused by OHSS,therefore guiding clinical work.