【摘要】：目的:建立瘢痕子宮產(chǎn)前預(yù)測改良評分法,評估剖宮產(chǎn)后再次妊娠的患者陰道試產(chǎn)結(jié)局的風(fēng)險。方法:參考《頭位分娩評分法》及《bishop評分法》,建立瘢痕子宮產(chǎn)前預(yù)測改良評分法(簡稱改良評分法),繪制并與Weitein's法、Flamm法的ROC曲線下面積進行比較。根據(jù)改良評分法的ROC曲線得到最佳截斷點,并以此分析改良評分法分值與試產(chǎn)結(jié)局的關(guān)系。結(jié)果:改良評分法的ROC曲線下面積(0.988)明顯大于Weitein's法(0.577)和Flamm法(0.616),3種診斷效率的比較,差異有統(tǒng)計學(xué)意義(P0.05)。改良評分法的ROC曲線得到最佳截斷點為18分,改良評分法評分18分的陰道分娩率(94.8%)高于評分≤18分(5.6%),差異有統(tǒng)計學(xué)意義(P0.05);陰道分娩組(93例)的評分(22.33±1.94分)明顯高于剖宮產(chǎn)組(39例)的評分(14.35±1.87分),差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:改良評分法的診斷效率較傳統(tǒng)方法高,能較好評估剖宮產(chǎn)后再次妊娠陰道試產(chǎn)的結(jié)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，

本文編號：2312524