子宫肌瘤挖除术后复发相关因素分析

Analysis of related factors of recurrence after myomectomy

目的探讨子宫肌瘤挖除术后复发的相关因素。方法收集因子宫肌瘤行子宫肌瘤挖除术并得以随访的441例患者的临床资料,回顾并记录患者手术时年龄、体质量指数、术前产次及肌瘤生长的部位、大小、数目等情况;计算术后复发率;对与复发可能的相关因素进行单因素和多因素分析。结果平均随访(37.79±18.64)个月,复发125例,5年累积复发率为38.9%。患者的手术年龄、体质量指数、肌瘤数目、术前产次是术后肌瘤复发的相关因素(P<0.05)。子宫肌瘤生长的部位、大小、术前绝经、肌瘤变性、特殊类型子宫肌瘤、手术方式、术前和术后妊娠及用药、术后宫内放置节育器及初潮年龄与复发无关。结论子宫肌瘤挖除术患者的手术年龄、体质量指数和子宫肌瘤的数目是术后复发的危险因素,术前产次是术后复发的保护因素。

Objective To study the related factors of recurrence after myomectomy. Methods The clinical data of 441 cases with myomectomy were collected. The age at the time of operation, body mass index（BMI）, preoperative parity, and the location, size and number of myomas were recorded, and the postoperative recurrence rate was calculated. Univariate and multivariate analysis were performed for possible factors related to recurrence. Results The average time of follow-up was（37.79 ± 18.64） months. Recurrence was found in 125 cases, and 5-year cumulative rate of recurrence was 38.9%. The age at the time of operation, BMI, number of myomas and preoperative parity were related factors of recurrence（ P 〈 0.05）. The location and size of myomas, preoperative menopause, myoma degeneration, pathology, way of operation, preoperative and postoperative medications and pregnancy, intrauterine contraceptive device after operation and the age of menarche were not related to the rate of recurrence. Conclusion The age at the time of operation, BMI and number of myomas are the risk factors of recurrence, while the preoperative parity is the protective factor of recurrence.