全子宫切除术后盆腔肿块发生高危因素分析

Analysis of the high risk factors of pelvic mass occurrence of patients after total hysterectomy

目的:探讨全子宫切除术后出现盆腔肿块高危因素,分析预防对策。方法:回顾性选取2019年1月-2022年1月东本院确诊的全子宫切除术后1年出现盆腔肿块患者30例为盆腔肿块组,未出现盆腔肿块患者120例为对照组。比较两组一般人口学资料、孕产史、既往病史、疾病类型、手术资料,使用单因素分析、多因素logistic回归分析明确全子宫切除术后出现盆腔肿块的影响因素;采用受试者工作特征(ROC)曲线分析独立危险因素对术后出现盆腔肿块预测效力。结果:糖尿病、肾脏合并症、术前贫血、子宫内膜异位症史、盆腔手术史、腹部手术史、输卵管处理方式、手术时间、术中出血量均可能与全子宫切除术后出现盆腔肿块有关(P<0.2);多因素logistic回归分析显示,术前贫血(OR=2.969,95%CI 1.348~6.540)、子宫内膜异位症史(OR=2.651,95%CI 1.413~4.975)、腹部手术史(OR=2.280,95%CI 1.236~4.206)、输卵管处理方式为保留双侧输卵管(OR=2.528,95%CI 1.271~5.028)、手术时间长(OR=1.106,95%CI 1.016~1.204)均为全子宫切除术后出现盆腔肿块独立危险因素(P<0.05);ROC曲线分析显示,上述5个独立危险因素均对全子宫切除术后出现盆腔肿块具有一定预测效力,曲线下面积分别为0.717、0.621、0.608、0.633、0.652。结论:临床应重视全子宫切除术后出现盆腔肿块高危因素,据此加强围术期管理。

Objective:To explore the high risk factors of pelvie mass occurrence of patients after total hysterctomy,and to study its preventive measures.Methods:In 1 year after total hysterectomy,30 patients with pelvic masses oc-currence from January 2019 to January 2022 were selected in study group retrospectively.and 120 patients without pel-vic masses occurrence were sclected in control group.The general demographic data,the pregnancy history,the past medical history,the discase type,and the surgical data of the patients were compared between the two groups.Univa-riate analysis and multivariate logistic regression analysis were used to identify the influencing factors of the pelvic mas-ses occurrence of the patients after total hysterectomy.The rceiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of the independent risk factors for their postoperative pelvic mass occurrence.Results:.The diabetes mellitus,the renal complications,the preoperative anemia,the histories of endometriosis,pelvic surger-y.and abdominal surgery.the treatment mode of fllpian tube,the operation time,and the intraoperative blood loss of the patients might be related to the occurrence of their pelvic mass occurrence after total hysteroctomy(P<0.05).Multivariate logistie regression analysis showed that the preoperative history of anemia(OR=2.969,95%CI-1.348-6.540),the endometriosis history(OR-2.651,95%CI-1.413-4.975).the abdominal surgery history(OR-2.280,95%CI-1.236-4.206),the treatment of bilateral tubal retention(OR-2.528,95%CI-1.271-5.028),the longer op-eration time(OR-1.106,95%CI-1.016-1.204)of the patients were all the independent risk factors of their pelvic mass occurrence after total hysterectomy(P<0.05).ROC curve analysis showed that the histories of preoperative his-tory of anemia,endometriosis,and abdominal surgery.the treatment methods of bilateral tubal retention,and the op-eration time of the patients had certain predictive eficcy for the occurrence of their pelvie mass after total hysterecto-my,and the area under the curve of which were 0.717.0.621,0.608,0.633,and 0.652.respetively.Conclusion:The high risk factors of the pelvic mass occurrence after total hysterectomy of the patients should be paid attention to in clinic,and the perioperative management should be strengthened according to these high risk factors.