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目的 调查盆腔器官脱垂患者对子宫托治疗的依从性并分析其影响因素。方法 选择106例首次佩戴子宫托成功的患者，收集其临床资料并随访3、6、12个月，记录佩戴率，以佩戴子宫托12个月者为依从组，佩戴少于12个月者为不依从组；采用多因素Logistic回归分析探讨影响子宫托依从性的因素，使用受试者操作特征（ROC）曲线评估有利于持续佩戴子宫托的指标。结果 纳入依从组患者62例，不依从组44例；随访3、6、12个月的子宫托持续佩戴率分别为96.23%(102例)、77.36%(82例)、58.49%(62例)；多因素Logistic回归分析显示年龄、阴裂（gh）、阴道总长度（TVL）为盆腔器官脱垂患者对子宫托治疗依从性的独立影响因素（P<0.05）；年龄> 64岁[ROC曲线下面积（AUC）=0.754]、gh<3 cm(AUC=0.626)、TVL > 7 cm(AUC=0.728)的患者持续佩戴子宫托比例更高，且年龄、gh、TVL可作为盆腔器官脱垂患者子宫托治疗依从性的预测指标；44例患者终止使用子宫托的原因包括自觉子宫托护理繁琐（9例）、自觉原有脱垂症状消失（4例）、受孕（3例）、认为治疗效果不佳（4例）以及并发症（24例）。结论 盆腔器官脱垂患者短期内使用子宫托治疗的依从性高，但随着使用时间的延长，依从性受年龄、gh和TVL的影响而降低。年龄> 64岁、gh<3 cm和TVL > 7 cm可作为子宫托治疗依从性降低的预测指标。
Abstract：Objective To investigate the treatment compliance of pessary therapy in patients with pelvic organ prolapse(POP) and analyze its influencing factors. Methods A total of 106 patients who successfully used pessary for the first time were selected as the study subjects. Clinical data were collected and follow-ups made, and adherence rates recorded at 3, 6, and 12 months. Patients who used the pessary for 12 months were categorized as adherent, while those who used it for less than 12 months as non-adherent. Multivariate Logistic regression analysis was used to explore factors affecting adherence, and receiver operating characteristics(ROC) curves assessed indicators favoring continued use. Results There were 62 adherent and 44 non-adherent patients. Adherence rates were 96.23%(102 patients) at 3 months, 77.36%(82 patients) at 6 months, and 58.49%(62 patients) at 12 months. Multivariate Logistic regression analysis showed that age, genital hiatus(gh), and vaginal total length(TVL) were independent factors influencing adherence(P<0.05). ROC curves indicated that patients older than 64 years(AUC=0.754), with gh less than 3 cm(AUC=0.626) and TVL greater than 7 cm(AUC=0.728) had higher adherence rates. These factors could help predict adherence to pessary treatment. Reasons for discontinuation among the 44 patients included cumbersome care(9 cases), disappearance of prolapse symptoms(4 cases), pregnancy(3 cases), perceived ineffectiveness(4 cases), and complications(24 cases). Conclusion Short-term adherence to pessary treatment is high among pelvic organ prolapse patients, but decreases over time due to age, gh, and TVL. Age > 64 years, gh < 3 cm, and TVL > 7 cm are predictive indicators of decreased adherence.
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基本信息:
DOI：10.13885/j.issn.2097-681X.2025.07.008
中图分类号:R711.2
引用信息:
[1]熊正花,苗娅莉,陆金芝等.盆腔器官脱垂患者子宫托治疗的依从性及影响因素分析[J].兰州大学学报(医学版),2025,51(07):54-59+68.DOI:10.13885/j.issn.2097-681X.2025.07.008.
基金信息:
云南省“万人计划”名医专项人才项目(RLHXS20210331); 云南省卫生健康委员会医学领军人才培养计划项目(L-2019005)