卵巢子宫内膜异位症患者腹腔镜保守性手术后复发相关因素分析

Associated Factors for Relapse of Ovarian Endometriosis after Laparoscopic Surgery

目的:探讨卵巢子宫内膜异位症患者腹腔镜保守性手术后复发的影响因素。方法:回顾分析2012年6月-2016年6月在郑州大学第三附属医院妇科行腹腔镜保守性手术且术后按纳入条件随访资料完整的卵巢子宫内膜异位症304例的临床资料,以术后2年内复发的70例为观察组,以未复发的234例为对照组,采用单因素及多因素Logistic回归分析法分析复发的相关影响因素。结果:单因素回归分析在年龄、术前痛经、术前产次、既往治疗史、既往就诊医院级别、卵巢囊肿侧别、手术分期、术后药物(促性腺激素释放激素激动剂,Gn RH-a)治疗、术后妊娠均与卵巢子宫内膜异位症复发相关(P<0.05)。多因素回归分析显示,术前痛经、既往药物治疗、双侧卵巢囊肿是卵巢子宫内膜异位症复发的危险因素。而年龄大、既往就诊三级甲等医院、术后药物(Gn RH-a)治疗、术后妊娠4个因素是卵巢子宫内膜异位症复发的保护因素。结论:对有高危因素的卵巢子宫内膜异位症患者,应选择级别高的医院就诊,早期发现、早期手术,采取创伤小、能彻底清除病灶的个体化治疗方案,术后相关药物治疗及术后受孕可以有效预防子宫内膜异位症的发生。

Objective:To investigate the influencing factors of recurrence after laparoscopic conservative surgery in patients with ovarian endometriosis.Method:From June 2012 to June 2016 in the Third Affiliated Hospital of Zhengzhou University gynecological laparoscopic conservative surgery and postoperative follow-up data included 304 patients according to the condition of complete ovarian endometriosis,with postoperative recurrence within 2 years of the 70 cases of the observation group,with no recurrence in 234 cases as the control group,using logistic single factor and multiple regression analysis of recurrence related factors.Result:Single factor regression analysis of age,preoperative dysmenorrhea,preoperative production,previous treatment history,previous hospital level,ovarian cyst side,surgical stage,postoperative drug(GnRH-a)treatment,postoperative pregnancy and ovarian endometriosis recurrence were statistically significant(P<0.05).Multivariate regression analysis showed that preoperative dysmenorrhea,previous drug treatment,bilateral ovarian cysts were risk factors for recurrence of ovarian endometriosis.Four factors,including age,previous treatment of three hospitals,Objective:To investigate the influencing factors of recurrence after laparoscopic conservative surgery in patients with ovarian endometriosis.Method:From June 2012 to June 2016 in the Third Affiliated Hospital of Zhengzhou University gynecological laparoscopic conservative surgery and postoperative follow-up data included 304 patients according to the condition of complete ovarian endometriosis,with postoperative recurrence within 2 years of the 70 cases of the observation group,with no recurrence in 234 cases as the control group,using logistic single factor and multiple regression analysis of recurrence related factors.Result:Single factor regression analysis of age,preoperative dysmenorrhea,preoperative production,previous treatment history,previous hospital level,ovarian cyst side,surgical stage,postoperative drug(GnRH-a)treatment,postoperative pregnancy and ovarian endometriosis recurrence were statistically significant(P<0.05).Multivariate regression analysis showed that preoperative dysmenorrhea,previous drug treatment,bilateral ovarian cysts were risk factors for recurrence of ovarian endometriosis.Four factors,including age,previous treatment of three hospitals,high level of hospital treatment,early detection,early surgery,taking trauma,can completely remove the lesion of the individualized treatment plan.Postoperative related drug therapy and postoperative pregnancy can effectively prevent the occurrence of endometriosis.