子宫肌瘤剔除术后复发的危险因素分析

The risk factors analysis of recurrence of hysteromyoma after myomectomy

目的 探讨子宫肌瘤剔除术后复发的危险因素.方法 回顾性分析2007年5月～2011年4月期间深圳市龙岗中心医院收治的432例子宫肌瘤患者的临床资料,根据子宫肌瘤剔除术后是否复发将其分为复发组与未复发组,对可能相关的临床资料进行单因素与多因素Logistic回归分析,以探讨剔除术后复发的危险因素.结果 子宫肌瘤剔除术后复发率为23.4％（101/432）,两组患者年龄、月经初潮年龄、术前分娩次数、BMI、子宫肌瘤个数、肌瘤直径及术后妊娠等方面比较,差异均具有统计学意义（P＜ 0.05）;Logistic回归分析显示年龄＜40岁、初潮年龄较早、BMI较高、肌瘤个数较多均为子宫肌瘤剔除术后复发的独立危险因素（P＜0.05）,术后妊娠史是其保护性因素（P＜0.01）.结论 子宫肌瘤剔除术后复发危险因素较多,对于具有上述危险因素的患者应慎重选择该手术方式,且术后应密切随访,如有异常,及时处理.

Objective To study the risk factors of recurrence of hysteromyoma after myomectomy.Methods The clinical data of 432 patients with hysteromyoma from May 2007 to April 2011 in the Longgang Central Hospital of Shenzhen City were retrospective analyzed and divided into the recurrent group and non recurrent group according to with or without the recurrence after myomectomy.The possibly relative clinical data were analyzed by single factor and multiple factors Logistic regression analysis in order to research the risk factors for recurrence of hysteromyoma after myomectomy.Results The recurrence rate of hysteromyoma after myomectomy was 23.4％ （101/432） in these patients.The age,menarche age,delivery times before surgery,BMI,number of hysteromyoma,diameter of hysteromyoma and postoperative gestation had significant difference between the two groups （P ＜ 0.05）.Logistic regression analysis showed that age below 40 years old,earlier menarche age,high BMI,more number of hysteromyoma were the independent factors of recurrence of hysteromyoma after myomectomy （P ＜0.05）.The history of postoperative gestation was the protective factor （P ＜ 0.01）.Conclusion There are many risk factors of the recurrence of hysteromyoma after myomectomy.Patients with these risk factors should be carefully selected the myomectomy,should be followed intently and treated in time when in abnormal situation.