腹腔镜下子宫肌瘤剔除术中出血相关风险因素的Logistics回归分析

Logistics regression analysis of risk factors of blood loss during laparoscopic myomectomy

目的探讨腹腔镜下子宫肌瘤切除术中出血的相关风险因素。方法收集本院2013年1月至2015年6月收治子宫肌瘤患者198例,根据术中的出血量,分为观察组(出血量≥100ml)和对照组(出血量<100ml),行单因素对比分析及多因素的Logistics回归分析两组患者的观察指标。结果共有58例(29.3%)患者术中出血大于100ml。与对照组相比,观察组肌瘤直径≥5cm、多发肌瘤、肌壁间肌瘤和宫颈或子宫后壁下段的患者构成比明显更高,差异具有统计学意义(P<0.05),且子宫肌瘤直径≥5cm、多发肌瘤、肌壁间肌瘤和宫颈或子宫后壁下段可显著增加子宫肌瘤患者LM术中出血的风险(P<0.05)。结论子宫肌瘤患者LM术中出血的风险与术前肌瘤个数、肌瘤直径、肌瘤类型及肌瘤位置等多方面因素相关,术前应综合评估患者术中出血的风险因素,完善术前准备。

Objective To determine the risk factors of blood loss during laparoscopic myomectomy. Methods 198 cases of uterine fibroids were collected in our hospital from January 2013 to June 2015. According to the amount of blood loss, patients were divided into observation group（blood loss≥100ml） and control group（blood loss〈100ml）. The observation index were analyzed by single factor and multi factor logistics regression analysis. Results A total of 58 patients（29.3%） had intraoperative bleeding more than 100 ml. Compared with the control group, constitute ratio of patients in the observed group at least 5 cm in diameter, multiple fibroids and myometrium myoma and uterine cervix or uterus wall segment was significantly higher, the difference was statistically significant（P〈0.05）. Uterine fibroids diameter greater than or equal to 5cm, multiple fibroids and myometrium between fibroids and cervical or uterine rear wall sections could be a significant increase in the risk of bleeding in patients with LM of myoma of uterus（P〈0.05）. Conclusion The risk of bleeding during the operation of LM in patients with uterine fibroids was related to the number,the diameter, the type and the location of the myoma. Preoperative evaluation should be taken to assess the risk factors of intraoperative bleeding.