摘要
目的:通过盆底功能障碍问卷简短版-20(PFDI-20)问卷调查分析不同C型手术方式对子宫颈癌患者术后盆底功能状况和生活质量的影响,应用列线图构建术后影响生活质量的风险预估模型。方法:按1∶1倾向性评分匹配出保留盆腔自主神经的子宫广泛性切除术(NSRH)和经典的子宫广泛性切除术(RH)两组患者,对比分析两组的生活质量评分;采用单因素和多因素Logistic逐步分析法寻找影响生活质量的危险因素,并使用列线图建立预估模型,采用C-index值和校正曲线评估模型的预测精准度。结果:(1)NSRH组纳入40例,RH组纳入40例,NSRH组和RH组PFDI-20总分值分别为0(0,7.292)分、4.167(0,27.344)分,差异有统计学意义(P<0.05);其中NSRH组的盆腔器官脱重症状问卷(POPDI-6)分值为0(0,0)分,显著低于RH组的0(0,5.208)分,差异有统计学意义(P<0.05)。(2)Nomogram模型的C-index值为0.725,提示模型准确度较好;校正曲线平均绝对误差为0.04,提示模型预测风险与实际风险符合度较好。(3)NSRH组术后不同辅助治疗患者的POP-DI-6分值、CRADI-8分值、UDI-6分值、PFDI-20分值比较,差异均无统计学意义(P>0.05)。结论:与RH相比,NSRH能有效改善子宫颈癌患者的盆底功能和生活质量,术后辅助治疗方式不影响生活质量。建立的列线图模型可实现对子宫颈癌术后影响生活质量的个体化预测,应用方便。
Objective:To investigate the effects of different type C surgical methods on postoperative pelvic floor function and quality of life in patients with cervical cancer through pelvic floor distress inventory-short form 20(PFDI-20),and to construct a risk prediction model that affects the quality of life after surgery using the nomogram.Methods:According to the 1∶1 propensity score matching,two groups of patients with NSRH and RH were matched.The quality of life scores of the two groups were compared and analyzed.Univariate and multivariate logistic stepwise analysis were used to find the risk factors that affect the quality of life,and the nomogram was used to build a prediction model,and The C-index value and correction curve were used to evaluate the prediction accuracy of the model.Results:(1)40 cases were included in the NSRH group and 40 cases in the RH group.The total PFDI-20 scores of the NSRH group and the RH group were 0(0,7.292)points and 4.167(0,27.344)points respectively,the difference was statistically significant(P<0.05).The POPDI-6 score of the NSRH group was 0(0,0)points,which was significantly lower than the 0(0,5.208)points of the RH group(P<0.05).(2)The C-index value of the Nomogram model was 0.725,which indicated that the accuracy of the model was good;the average absolute error of the calibration curve was 0.04,which indicated that the predicted risk of the model was in good agreement with the actual risk.(3)Comparing the POPDI-6 score,CRADI-8 score,UDI-6 score,and PFDI-20score of patients in the NSRH group with different adjuvant treatments after surgery,there was no statistically significant difference(P>0.05).Conclusions:Compared with RH,NSRH can effectively improve the pelvic floor function and quality of life of patients with cervical cancer.Postoperative adjuvant treatment does not affect the quality of life.The established nomogram model can realize the personalized prediction of the quality of life after cervical cancer surgery,and it is convenient for application.
作者
唐玲玲
李力
TANG Lingling;LI Li(Department of Gynecologic Oncology and Affiliated Tumor Hospital of Guangxi Medical University and Regional High-risk Cancer Early Prevention Research Key Laboratory of Ministry of Education,Nanning Guangxi 530021,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2021年第6期447-451,共5页
Journal of Practical Obstetrics and Gynecology
基金
广西科学研究与技术开发计划课题(编号:桂科攻14124004)。