35～45岁子宫肌瘤患者术后复发的临床特点及相关影响因素分析

Analysis on clinical features and related influencing factors of postoperative recurrence in patients with uterine fibroid aged 35-45 years old

目的探讨35～45岁子宫肌瘤患者术后复发的临床特点及相关影响因素。方法选取2014年1月-2017年8月在乐山市妇幼保健院行子宫肌瘤剔除术治疗的212例子宫肌瘤患者为研究对象,回顾性分析患者的临床症状、妊娠次数、分娩史、初潮年龄、病理类型、合并妇科疾病、手术途径、子宫大小、肌瘤数量、肌瘤大小、肌瘤生长部位、术后药物治疗、肌瘤变性等情况,分析子宫肌瘤剔除术术后复发的危险因素。结果 212例子宫肌瘤患者经随访共有98例患者复发,复发率为46. 23%,其中无症状占36. 73%(36/98)、有症状占63. 27%(62/98)。临床症状以月经改变最为常见,占31. 63%(31/98),其次为腹部包块、腰腹部症状,分别占14. 29%(14/98)、13. 27%(13/98)。年龄、肌瘤数量、肌瘤生长部位、随访时间、初潮年龄与肌瘤复发有关,差异有统计学意义(P<0. 05);肌瘤复发与最大肿瘤直径、手术途径、病理类型、妊娠次数、分娩史、合并妇科疾病、症状、肌瘤变性、术后药物治疗无关,差异无统计学意义(P>0. 05)。多因素Logistic回归分析结果显示,年龄、随访时间、肌瘤数量、肌瘤生长部位与肌瘤复发呈正相关关系(OR>1),初潮年龄与肌瘤复发无明确相关性(OR<1)。结论 35～45岁子宫肌瘤患者术后复发以月经改变、腹部包块、腰腹部症状等最为常见,年龄、随访时间、肌瘤数量、肌瘤生长部位与子宫肌瘤剔除术术后复发呈正相关关系。

Objective To explore the clinical features and related influencing factors of postoperative recurrence in patients with uterine fibroid aged 35-45 years old. Methods A total of 212 patients with uterine fibroid undergoing myomectomy in Leshan Municipal Maternal and Child Health Care Hospital from January 2014 to August 2017 were selected as research object. The clinical symptoms,times of pregnancy,delivery history,age of menarche,pathological type,combined gynecological diseases,surgical approach,uterine size,number of uterine fibroid,size of uterine fibroid,location of uterine fibroid,postoperative drug therapy,and degeneration of uterine fibroid in these patients were retrospectively analyzed. The risk factors of recurrence after myomectomy were analyzed. Results Among 212 patients,recurrence was observed in 98 patients,the recurrence rate was 46. 23%. The proportions of patients without symptoms and with symptoms accounted for 36. 73%( 36/98) and 63. 27%( 62/98),respectively. Menstrual change was the most common clinical symptom,accounting for 31. 63%( 31/98),followed by abdominal mass( 14. 29%,14/98) and abdominal symptoms( 13. 27%,13/98). Age,number of uterine fibroid,location of uterine fibroid,follow-up time,and time of menarche were correlated with the recurrence of uterine fibroid( P<0. 05). The recurrence of uterine fibroid was not correlated with the maximum diameter of tumor,surgical approach,pathological type,times of pregnancy,delivery history,combined gynecological diseases,symptoms,degeneration of uterine fibroid,and postoperative drug therapy( P>0. 05). Multivariate logistic regression analysis showed that age,follow-up time,number of uterine fibroid,and location of uterine fibroid were positively correlated with recurrence of uterine fibroid( OR> 1),there was no significant correlation between the age of menarche and recurrence of uterine fibroid( OR<1). Conclusion Menstrual change,abdominal mass,and abdominal symptoms were the most common symptoms of postoperative recurrence in patients with uterine fibroid aged 35-45 years old. Age,follow-up time,number of uterine fibroid,and location of uterine fibroid are positively correlated with recurrence of uterine fibroid.