数据驱动的诊断和临床表现高调的骨盆底功能障碍
Sara R Till1, Andrew Schrepf2, Anne Arewasikporn2
1Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr. Ann Arbor, MI 48109.
高音调的骨盆底功能障碍 (HTPFD) 诊断时,疼痛度得分>12/60. HTPFD与持续的骨盆疼痛有关,由活动加剧,并以痛苦的性交和性功能受损为特征.
科学领域:
- 盆腔健康 盆腔健康
- 慢性疼痛管理 慢性疼痛管理
- 女性生殖健康 妇女生殖健康
背景情况:
- 高音调的骨盆底功能障碍 (HTPFD) 在患有骨盆疼痛的女性中很普遍,但缺乏标准化的诊断标准和评估策略.
- 关于HTPFD临床表现的初级数据有限,目前的文献依赖于专家意见而不是患者报告的数据.
- 缺乏共识阻碍了对HTPFD的准确识别和有效治疗评估.
研究的目的:
- 为了建立一个与患者报告的疼痛再生产相关的骨盆肌肉肌肌痛评分.
- 为了比较HTPFD和没有HTPFD的患者的临床表现.
主要方法:
- 一项横截面研究涉及612名慢性骨盆疼痛中心的患者.
- 患者填写了问卷,并接受了体检,包括对六个骨盆肌部位的触摸.
- 接收器操作特征 (ROC) 曲线分析确定了诊断敏感度得分,随后进行了临床表现的比较分析.
主要成果:
- 总体敏感度评分>12/60准确识别了HTPFD (敏感度为82.3%,特异性为79.1%).
- 患有HTPFD的患者 (63.6%) 报告了更持久的疼痛,体力活动加剧和辐射疼痛.
- HTPFD与失恋症显著相关,性功能恶化,与疼痛相关的避免性交.
结论:
- 盆地肌肉敏感度得分>12/60表明HTPFD.
- HTPFD与持续的,活动加剧的疼痛有关,这种疼痛可能会辐射并显著影响性功能.
- 发育不良和性功能受损是HTTPFD的关键指标.
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