现代妇产科进展2025，Vol.34Issue(8)：582-587,6.DOI:10.13283/j.cnki.xdfckjz.2025.08.032
剖宫产切口子宫内膜异位症临床预测模型构建
Construction of clinical prediction model of endometriosis through cesarean section inci-sion
摘要
Abstract
Objective:To investigate the influencing factors of cesarean section scar en-dometriosis(CSE)and establish a nomogram prediction model.Methods:198 patients who at-tended the Third Affiliated Hospital of Zhengzhou University from January 2017 to March 2024 and were diagnosed with CSE by postoperative pathology(case group)and 198 patients with a history of cesarean section but attended for non-CSE benign gynecological diseases during the same period(control group)were selected.Independent factors influencing the occurrence of CSE were determined by univariate analysis and multifactorial logistic regression analysis of the clinical data of the two groups of patients.Using R software,a column-line graph prediction model was constructed,and this model was evaluated and validated.Results:The results of uni-variate analysis showed that CSE was correlated with the number of deliveries,the number of ce-sarean sections,the time of menstrual recurrence,the time of breastfeeding,the duration of men-struation,the history of primary dysmenorrhea,whether or not full-term cesarean section was performed,indications for cesarean section,whether or not the cesarean section was combined with hemorrhage,and the way of cesarean section surgical incision(P<0.05).Further multifac-torial logistic regression analysis identified the following independent influences:history of pri-mary dysmenorrhea(OR=1.675,95%CI:1.030～2.724),indication for cesarean section(OR=2.147,95%CI:1.094～4.213),method of cesarean section incision(OR=3.676,95%CI:1.051～12.587),combined hemorrhage at the time of cesarean section(OR=4.113,95%CI:1.019～16.505),time to breastfeeding after cesarean section(OR=3.243,95%CI:1.991～5.282),and time to menstrual resumption after cesarean section(OR=2.151,95%CI:1.230～3.762).A column-line graph prediction model was constructed based on the above in-fluencing factors,and the area under the ROC curve was 0.763(95%CI:0.716～0.809),and the area under the ROC curve for internal validation was 0.741(95%CI:0.692～0.789).Conclusions:Primary dysmenorrhea,indication for cesarean section,method of surgical incision for cesarean section,combined hemorrhage at cesarean section,duration of breastfeeding after cesarean section,and duration of menstrual resumption after cesarean section were all independ-ent influences on the occurrence of CSE,and the column-line diagram model constructed based on the above influences showed good differentiation,calibration,and clinical usefulness.关键词
剖宫产切口子宫内膜异位症/影响因素/剖宫产手术方式/列线图/预测模型Key words
Cesarean section incision endometriosis/Influencing factors/Caesarean section operation mode/Nomogram/Prediction model分类
医药卫生引用本文复制引用
冯晓倩,刘弘扬,李颖颖,王媛媛,封全灵..剖宫产切口子宫内膜异位症临床预测模型构建[J].现代妇产科进展,2025,34(8):582-587,6.基金项目
河南省自然科学基金(No:232300421286) （No:232300421286）
