腹腔镜术后特殊类型子宫肌瘤复发的相关因素和病理分析

目的探讨腹腔镜术后特殊类型子宫肌瘤复发的相关因素和病理特点。方法2009年1月至2014年10月腹腔镜术后经病理检查证实为特殊类型子宫肌瘤患者84例。对患者进行术后随访，记录患者年龄、病程、既往妊娠史、分娩史、肌瘤数目、肌瘤大小、肌瘤部位等，分析上述因素与复发率的关系。结果对84例患者术后随访时间5-24个月，其中38例复发，复发率45．2％；复发时间平均为术后（13．78±4．72）个月。术后复发的相关危险因素包括既往分娩史、肌瘤数目与肌瘤直径，而与患者年龄、病程、既往妊娠史、子宫体积、肌瘤所达范围等因素无关。38例复发患者中，富细胞型平滑肌瘤37例，上皮样平滑肌瘤1例。结论腹腔镜术后特殊类型子宫肌瘤复发的主要危险因素为患者有既往分娩史、肌瘤多发及肌瘤直径≥6cm。从病理类型分析富细胞型平滑肌瘤的复发最常见，在，临床上尤其应关注这些高危因素。采取相应预防措施降低术后复发率。

Objective To analyze the correlation factors and pathological features in recurrent patients with special hysteromyoma after the laparoscopic surgery. Methods 84 patients with special hysteremyoma from January 2009 to October 2014 in our hospital were selected in our study. The recurrence rate and the patient＇ s age, disease course, history of pregnancy, birth history, counts, size and position of hysteromyoma were analyzed. Results During 5-24m of follow-up visits, there were 38 recurrent cases （ 45.2% ） ; the average recurrent time was （ 13.78 ± 4.72 ） m. It was known that the risk factors for recurrent patients including the birth history, counts and diameter of hysteromyoma; there were no correlation with the patient＇ s age, disease course, history of pregnancy, uterine volume and invaded range.There were 37 cases with cellular myoma and 1 case with epithelioid leiomyoma. Conclusion After the laparoscopic surgery, the major risk factors of special hysteromyoma including the birth history, multiple myoma and diameter of myoma （ ≥6cm ） .According to the pathological types, the cellular myoma is commonly seen.In clinical practice, it needs to focus on these risk factors and take the prevention measures to reduce the recurrent rate.