Đánh giá tình trạng chảy máu bất thường từ tử cung dựa vào biểu đồ PBAC ở phụ nữ trong độ tuổi sinh sản và các yếu tố liên quan

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Minh Đạt Hồ, Phước Thành Lê, Công Lợi Nguyễn, Doãn Tú Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 362.198 Social welfare problems and services

Thông tin xuất bản: Tạp chí Phụ sản, 2023

Mô tả vật lý: 60-66

Bộ sưu tập: Metadata

ID: 502279

Thêm vào giỏ

Đánh giá tình trạng chảy máu bất thường từ tử cung ở phụ nữ trong độ tuổi sinh sản dựa vào biểu đồ PBAC, khảo sát nguyên nhân theo hệ thống phân loại PALM-COEIN và tìm hiểu các yếu tố liên quan. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang, hồi cứu với 180 phụ nữ trong độ tuổi sinh sản (18 - 54 tuổi) nhập viện vì chảy máu bất thường từ tử cung tại Khoa Phụ sản, Bệnh viện Trường Đại học Y-Dược Huế và Bệnh viện Trung ương Huế từ tháng 06/2021 đến 12/2022. Tiến hành thăm khám lâm sàng, đánh giá tình trạng, mức độ chảy máu bằng biểu đồ PBAC. Dựa vào kết quả cận lâm sàng đánh giá mức độ thiếu máu. Hội chẩn để chẩn đoán nguyên nhân theo hệ thống phân loại PALM-COEIN. Tính toán và khảo sát các yếu tố liên quan đến tình trạng chảy máu bất thường từ tử cung. Kết quả: Độ tuổi trung bình trong nghiên cứu là 41,9 ± 6,3 (tuổi). Có 56,1% bệnh nhân được chẩn đoán thiếu máu
trong đó, thiếu máu mức độ nặng chiếm tỷ lệ 7,2%. U xơ tử cung (UXTC) và quá sản nội mạc tử cung (NMTC)/ung thư NMTC là những nguyên nhân chủ yếu với tỷ lệ lần lượt là 51,1% và 38,9% và cũng có điểm PBAC cao nhất với giá trị trung vị lần lượt là 498,0 (KTC 95%: 336,0 - 750,0) và 529,0 (KTC 95%: 289,0 - 884,3). Tại điểm cắt tối ưu là 590, giá trị của PBAC trong tiên lượng thiếu máu mức độ nặng là: độ nhạy 86,7%, độ đặc hiệu 63,6%, AUC = 0,745 (KTC 95%: 0,675 - 0,807), p = 0,0001. Điểm PBAC >
590 có mối liên quan với tình trạng rong kinh và thiếu máu nặng (p <
0,05). Kết luận: Biểu đồ PBAC có thể ứng dụng trong thực hành lâm sàng giúp đánh giá mức độ chảy máu bất thường từ tử cung, có giá trị tiên lượng mức độ thiếu máu nặng.To evaluate abnormal bleeding from uterus according to the PBAC chart, causes according to the PALM-COEIN classification system and investigate some related factors. Materials and methods: A retrospective cross-sectional descriptive study was constructed: 180 women of reproductive age hospitalized for AUB at Department of Obstetrics and Gynecology, Hospital of Hue University of Medicine and Pharmacy and Hue Central Hospital from June 2021 to December 2022. Perform clinical examination, asssess the status of uterine bleeding in the last 2 months by PBAC chart. Based on the laboratory results, the surgical procedures chart to diagnose the cause according to the PALM-COEIN classification system and survey other aspects. Results: The mean age of this study is 41.9 ± 6.3. There are 56.1% of patients were diagnosed with anemia, in which severe anemia accounted for 7.2%. Leiomyoma and Malignacy and hyperplasia (endometrial) were the major causes with 51.1% and 38.9% respectively, and also had the highest PBAC score in group of structural causes. The median values were 490.0 (95% CI: 336.0 - 750.0) and 529.0 (95% CI: 289.0 - 884.3). At the optimal cut-off point of 590, the value of PBAC score in prognosis of severe anemia was: Sensitivity 86.7%, specificity 63.3%, are under the curve AUC) 0.745 (95% CI: 0.675 - 0.807), p = 0.0001. PBAC score >
590 has significantly correlation with menorrhagia and severe anemia (p <
0.05). Conclusion: The PBAC score is a practical tool that can be applied in clincal pratice to help assess the degree of abnormal uterine bleeding, which is valuable in predicting the severity of anemia.

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