宫腔镜下子宫内膜息肉切除术后复发率及危险因素分析

Analysis of Recurrence Rate and Risk Factors after Hysteroscopic Resection of Endometrial Polyps

目的:基于多因素logistic回归模型分析宫腔镜下子宫内膜息肉(EP)切除术后复发率及危险因素。方法:回顾性分析2021年6月至2022年6月在永煤集团总医院住院治疗的110例EP患者的临床资料,按出院后6个月预后情况(是否复发)分为复发组(13例)、未复发组(97例),比较两组患者的人口学、病理学资料以及血清学指标,分析影响宫腔镜下EP切除术后复发的危险因素。结果:本研究患者中,宫腔镜下EP切除术后复发率为11.82%(13/110);复发组患者合并多囊卵巢综合征、术后未使用避孕药的占比以及血清白细胞介素(IL)–23、肿瘤坏死因子(TNF)–α、黄体生成素(LH)、雌二醇(E2)水平与未复发组相比,差异均具有统计学意义(P<0.05);多因素logistic回归分析结果显示,合并多囊卵巢综合征、术后未使用避孕药以及血清IL–23、TNF–α、LH、E2水平高是宫腔镜下EP切除术后复发的危险因素(OR>1,P<0.05)。结论:合并多囊卵巢综合征、术后未使用避孕药以及血清IL–23、TNF–α、LH、E2水平高会增加宫腔镜下EP切除术后复发风险。

Objective To analyze the recurrence rate and risk factors of hysteroscopic endometrial polyp(EP)resection based on multivariate logistic regression model.Methods The clinical data of 110 EP patients hospitalized in Yongcoal Group General Hospital from June 2021 to June 2022 were retrospectively analyzed,and they were divided into a relapsed group(13 cases)and a non-recurrence group(97 cases)according to the prognosis 6 months after discharge(whether there was relapse or not),and compared the demographic and pathological data as well as the serological indexes of the two groups of patients,and analyzed the risk factors affecting the recurrence of EP after hysteroscopic EP resection.Results In this study,the recurrence rate after hysteroscopic EP resection was 11.82%(13/110);the percentage of patients with combined polycystic ovary syndrome,no postoperative use of contraceptive pills,and the levels of serum interleukin(IL)-23,tumor necrosis factor(TNF)-α,luteinizing hormone(LH),and estradiol(E2)levels were statistically significant(P<0.05)compared with the non-recurrence group.(E2)were statistically significant compared with the non-recurrence group(P<0.05);multifactorial logistic regression analysis showed that the combination of polycystic ovary syndrome,the non-use of contraceptive pills postoperatively,and the high serum levels of IL-23,TNF-α,LH,and E2 were the risk factors for recurrence(OR>1,P<0.05).Conclusion Comorbid polycystic ovary syndrome,lack of postoperative contraceptive use,and high serum IL-23,TNF-α,LH,and E2 levels increase the risk of recurrence after hysteroscopic EP resection.