绝经后盆腔器官脱垂的危险因素及盆底超声与POP-Q系统诊断一致性分析OA
Risk factors of postmenopausal pelvic organ prolapse and analysis of diagnostic consistency of pelvic floor ultrasound and POP-Q system
目的 探究绝经后妇女发生盆腔器官脱垂(POP)的危险因素,并分析盆底超声与盆腔器官脱垂定量分析(POP-Q)系统在绝经后POP诊断中的一致性.方法 回顾性收集2024年1-12月因盆底功能障碍性疾病相关症状就诊于唐山市妇幼保健院妇科门诊的240例绝经后妇女的病历资料,根据POP-Q系统评估方法将患者分为POP组(n=109)和非POP组(n=131),采用单因素和多因素Logistic回归分析绝经后妇女POP发生的危险因素,以Kappa值评估盆底超声检查和POP-Q系统诊断绝经后POP的一致性,并通过Pearson相关性分析评估两种方法测量值的相关性.结果 240例绝经后妇女中有109例(45.42％)发生POP.POP组阴道分娩次数≥3次、重体力工作、有盆腔手术史的比例高于非POP组,血清雌二醇水平低于非POP组(P＜0.05).多因素Logistic回归分析显示,阴道分娩次数≥3次、重体力工作、有盆腔手术史以及血清雌二醇水平下降是绝经后妇女发生POP的独立危险因素(P＜0.05).盆底超声与POP-Q系统诊断绝经后POP的一致性较好(Kappa值=0.687,P=0.407).POP-Q系统诊断结果显示,明显阴道前壁膨出44例、明显子宫脱垂56例、明显直肠壶腹膨出9例.Pearson相关性分析显示,POP-Q系统测量值与盆底超声测量值具有中高度相关性(P＜0.05).结论 绝经后妇女POP的发生与阴道分娩次数、工作性质、盆腔手术史以及血清雌二醇水平密切相关,且盆腔超声与POP-Q系统诊断绝经后POP的一致性较好.
Objective To investigate the risk factors of pelvic organ prolapse(POP)in postmenopausal women,and to analyze the consistency of pelvic floor ultrasound and pelvic organ prolapse quantification(POP-Q)system in the diagnosis of postmenopausal POP patients.Methods The medical records of 240 postmenopausal women who were treated in Gynecological Clinic of Tangshan Maternal and Child Health Hospital due to pelvic floor dysfunction-related symptoms from January to December 2024 were retrospectively collected.According to the POP-Q system evaluation method,the patients were divided into POP group(n=109)and non-POP group(n=131).Univariate and multivariate logistic regression analyses were used to analyze the risk factors of POP in postmenopausal women.Kappa value was used to evaluate the consistency between pelvic floor ultrasound examination and POP-Q system in the diagnosis of postmenopausal POP,and Pearson correlation analysis was adopted to evaluate the correlation between the measurements obtained by the two methods.Results Among 240 postmenopausal women,109(45.42％)developed POP.The proportions of vaginal delivery ≥3 times,heavy physical labor and history of pelvic surgery in the POP group were higher than those in the non-POP group,whereas the serum estradiol level was lower in the POP group(P＜0.05).Multivariate logistic regression analysis showed that vaginal delivery ≥3 times,heavy physical labor,history of pelvic surgery and decreased serum estradiol level were independent risk factors for POP in postmenopausal women(P＜0.05).Pelvic floor ultrasound exhibited good diagnostic consistency with the POPQ system for postmenopausal POP,with a Kappa value of 0.687(P=0.407).The diagnostic results of POP-Q system showed that there were 44 patients with obvious anterior vaginal wall prolapse,56 patients with obvious uterine prolapse and 9 patients with significant rectocele.Pearson correlation analysis showed that there was a moderate-to-high correlation between POP-Q system measurement and pelvic floor ultrasound measurement(P＜0.05).Conclusion The occurrence of POP in postmenopausal women is closely related to the number of vaginal deliveries,occupation type,history of pelvic surgery and the level of serum estradiol,and the consistency of pelvic ultrasound and POP-Q system is good in the diagnosis of postmenopausal women with POP.
张梦;张前;梁楠楠
唐山市妇幼保健院妇七科,河北唐山 063000唐山市妇幼保健院妇七科,河北唐山 063000唐山市妇幼保健院妇七科,河北唐山 063000
盆腔器官脱垂绝经危险因素盆底超声盆腔器官脱垂定量分析诊断
pelvic organ prolapsepostmenopausalrisk factorspelvic floor ultrasoundpelvic organ prolapse quantificationdiagnosis
《临床误诊误治》 2026 (18)
55-61,7
河北省医学科学研究重点课题计划项目(20251194)
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