子宫内膜异位症保守性手术后病变复发相关因素分析

Analysis of Factors Related to Recurrence of Endometriosis after Conservative Operation

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。

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 （x2=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.