保守性手术治疗子宫内膜异位症盆腔痛的疗效及影响因素分析

Analysis of Curative Effect of Conservative Surgery in Treatment of Peluic Pain of Syndrome Differentiation of TCM and Its Relevant Factors

目的探讨保守性手术治疗子宫内膜异位症盆腔痛的疗效及复发影响因素。方法整群收集2010年6月—2014年12月在该院拟行保守手术治疗的子宫内膜异位症患者132例,根据随访期间是否复发分为复发组和无复发组,对两组患者的临床资料进行单因素分析,同时进行多因素回归分析。结果复发组病变在双侧、有子宫内膜异位症手术史、R-AFS分期在Ⅳ期、术前CA125水平≥35 U/L、术后克罗米酚治疗的比例明显高于无复发组(P<0.05),复发组术后Gn RH-a治疗的比例明显低于无复发组(P<0.05);Logistic多因素分析显示,病变部位、子宫内膜异位症手术史、RAFS分期、术后克罗米酚治疗、术后Gn RH-a治疗是子宫内膜异位症的影响因素。结论病灶部位、既往子宫内膜异位症的手术史、R-AFS分期、术后克罗米酚治疗、术后Gn RH-a治疗均可影响子宫内膜异位症患者术后复发。

Objective To discuss the curative effect of conservative surgery in treatment of peluic pain of syndrome differentiation of tcm and its influence factors of recurrence. Methods 132 cases of patients with peluic pain of syndrome differentiation of tcm planning for conservative surgery in our hospital from June 2010 to December 2014 were collected and divided in to the recurrence group and no recurrence group according to whether the recurrence occurred or not during the follow-up period, and the clinical data of the two groups were given single-factor analysis and multi-factor regression analysis at the same time. Results The proportions of lesions in bilateral, surgical history of peluic pain of syndrome differentiation of tcm, Ⅳ stage in R-AFS staging, preoperative CA125 level ≥ 35 U/L and postoperative clomiphene treatment in the recurrence group were obviously higher than those in the no recurrence group,（P 〈0.05）, the proportion of postoperative Gn RH-a treatment in the recurrence group was obviously lower than that in the no recurrence group,（P〈0.05）, and the Logistic multi-factor analysis showed that the lesion position, surgical history of peluic pain of syndrome differentiation of tcm,R-AFS staging, postoperative clomiphene treatment and postoperative Gn RH-a treatment were the influence factors of peluic pain of syndrome differentiation of tcm. Conclusion The lesion position, surgical history of peluic pain of syndrome differentiation of tcm, R-AFS staging, postoperative clomiphene treatment and postoperative Gn RH-a treatment can all influence the postoperative recurrence of patients with peluic pain of syndrome differentiation of tcm.