子宫内膜异位症保守性手术后病变复发相关因素分析

摘要

Objective:To explore those factors of endometriosis (EMs) recurrence after conservative surgery. Methods:126 cases of EMs after conservative surgery from June 2008 to June 2012 were analyzed. They were divided into two groups:the non-recurrence group (89 cases) and the recurrent group (37 cases). Clinical data was Analyzed, those risk factors related to recurrence were evaluated. Results:In 126 cases, there were 19 cases with recurrence in the first year (15.08%), 14 cases with recurrence in the second year (11.11%) [totally, 33 cases (26.19%)], and 4 cases with recurrence in the third year (3.17%) after conservative surgery [total 37 cases (29.37%) in three years]. The number of recurrence cases increased with years after surgery (χ2=8.375, P=0.015). There is no significant difference in the previous surgical history between two groups (P<0.05). Those risk factors related to recurrence included the surgery history of conservative EMs surgery, pelvic diseases, postoperative r-AFS score, painful nodules in posterior vaginal fornix. Those protective factors included the time of pregnancy and treatment with mifepristone. Conclusions:Those risk factors and protective factors related to EMs recurrence after conservative surgery should be noticed, so as to predict prognosis and to guide clinical treatment.%目的：探讨子宫内膜异位症（EMs）保守性手术后病变复发的相关因素。方法：选取2008年6月-2012年6月于我院行EMs保守性手术治疗的患者126例，根据是否复发分为未复发组（89例）和复发组（37例），分析所有患者临床资料，观察病变复发情况并进行风险分析。结果：126例患者术后第1年复发19例（15.08%），第2年复发14例（11.11%），累计33例（26.19%）；第3年复发4例（3.17%），累计37例（29.37%）。以复发例数对时间做趋势卡方分析有统计学意义（χ2=8.375，P=0.015）。除既往EMs手术史2组差异无统计学意义外，其他因素差异均有统计学意义（P＜0.05）。多变量分析证实，EMs保守性手术后复发的危险因素包括既往EMs手术史、盆腔病变、术后r-AFS评分、后穹窿痛性结节，保护性因素包括术后孕次、米非司酮治疗。结论：临床治疗中应注意EMs保守性手术后病变复发危险因素和保护性因素，进而预测患者预后，指导临床治疗。