卵巢子宫内膜异位症保守性手术后复发因素研究分析

Risk factors for recurrence after endometriosis conservative surgery

目的 探讨分析卵巢子宫内膜异位症保守性手术治疗后复发的影响因素情况。方法 回顾性分析2010年1月至2020年12月本院收治的卵巢子宫内膜异位症并行保守性手术治疗患者共6040例,收集患者相关临床资料、病理结果以及随访情况。结果 手术治疗后根据术后随访情况,将6040例患者分为两组,其中观察组2011例,为术后复发者,对照组4029例,为术后未复发者。观察组中A型血患者比例明显高于对照组患者,而B型血患者比例小于对照组患者(P<0.05);两组患者O型血和AB型血患者比例无明显差异(P>0.05);观察组的糖类抗原199(CA199)、糖类抗原125(CA 125)及人附睾蛋白(HE4)水平均明显高于对照组(P<0.05);以子宫内膜异位症保守性手术治疗后复发作为因变量,采用Logitic回归分析,结果显示r-AFS高分期、肿瘤标志物相关指标高水平、术前伴发疾病、既往有盆腔手术治疗史、血型A均是卵巢子宫内膜异位症保守性手术后复发的独立危险因素。结论 手术治疗前r-AFS高分期、CA199、 CA125、HE4高水平、术前伴发相关疾病,既往有盆腔手术治疗史者、A型血均是卵巢子宫内膜异位症行保守性手术治疗后复发的独立危险因素。

Objective To investigate the factors affecting the recurrence of ovarian endometriosis after conservative surgery.Methods From January 2010 to December 2020,a total of 6040 patients with ovarian endometriosis who underwent conservative surgery were analyzed retrospectively,clinical data,pathological results and follow-up were collected.Results 6040 cases were divided into two groups according to the follow-up after operation,2011 cases in the observation group were recurrent after operation,and 4029 cases in the control group were non-recurrent after operation.The proportion of patients with blood type A in the observation group was significantly higher than that in the control group,while the proportion of patients with blood type B was lower than that in the control group(P<0.05),and there was no significant difference in the proportion of patients with blood type O and AB between the two groups(P>0.05).The levels of CA199,CA125 and HE4 in the observation group were significantly higher than those in the control group(P<0.05),and recurrence after conservative endometriosis operation was taken as dependent variable,using Logitic regression analysis,the results showed that high r-AFS stage,high level of tumor markers,preoperative disease,history of pelvic surgery,and blood type A were independent risk factors for recurrence after conservative ovarian endometriosis surgery.Conclusion High r-AFS stage,high levels of CA199,CA125,HE4 and associated diseases before operation,history of pelvic surgery and blood type A were independent risk factors for recurrence of ovarian endometriosis after conservative surgery.