术前超声联合血浆D-二聚体水平预测附件扭转角度≥720°

Preoperative ultrasound combined with plasma D-dimer levels for predicting adnexal torsion angle≥720°

目的观察术前超声联合血浆D-二聚体水平预测附件扭转(AT)角度≥720°的价值。方法回顾性分析94例经手术证实的单侧AT患者,根据术中评估扭转角度将其分为AT角度<720°组(n=36)及AT角度≥720°组(n=58)。采用单因素及多因素logistic回归分析筛选AT角度≥720°的临床及超声相关独立危险因素;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估单一及多项独立危险因素联合预测AT角度≥720°的效能。结果AT角度≥720°组生育史、血浆D-二聚体水平、手术途径、手术方式、超声所示扭转附件移位及受累卵巢水肿与AT角度<720°组差异均有统计学意义(P均<0.05)。血浆D-二聚体升高、超声显示扭转附件移位及受累卵巢水肿为预测AT角度≥720°的独立危险因素,三者联合的AUC为0.842。结论术前超声联合血浆D-二聚体水平可有效预测AT角度≥720°。

Objective To observe the value of preoperative ultrasound combined with plasma D-dimer level for predicting adnexal torsion(AT)angle≥720°.Methods Data of 94 patients with unilateral AT confirmed with surgical operation were retrospectively analyzed.The patients were divided into AT angle<720°group(n=36)or AT angle≥720°group(n=58)according to the torsion angle evaluated during surgical operation.Univariate analysis and multivariate logistic regression analysis were used to screen clinical and ultrasound-related independent risk factors for AT angle≥720°.Receiver operating characteristic(ROC)curves were drawn,and areas under the curve(AUC)were calculated to evaluate the efficacy of each independent risk factor alone and the combination for predicting AT angle≥720°.Results Significant differences of fertility history,plasma D-dimer level,surgical approach,surgical method,abnormal position of the adnexal mass and involved ovary edema detected with ultrasound were found between AT angle≥720°group and AT angle<720°group(all P<0.05).Increased plasma D-dimer,abnormal position of adnexal mass and involved ovary edema detected with ultrasound were all independent risk factors for AT angle≥720°,and the combined AUC of the above three indexes was 0.842.Conclusion Preoperative ultrasound combined with plasma D-dimer level could effectively predict AT angle≥720°.