子宫肌瘤剔除术后复发的影响因素及促性腺激素释放素激动剂的预防效果

Factors influencing recurrence of uterine fibroids and the preventive effectiveness of gonadotropin-releasing hormone agonist

目的探讨子宫肌瘤剔除术后患者复发的影响因素,并分析促性腺激素释放素激动剂(GnRH-a)的预防效果。方法选取2015年1月至2016年1月间空军军医大学第一附属医院收治的接受子宫肌瘤剔除术的211例患者,对患者进行随访,按照复发情况分为复发组和对照组,对两组患者临床资料进行子宫肌瘤复发的单因素分析和多因素Logistic回归分析。结果对211例患者随访3年后发现,63例患者复发,复发率为29. 9%。根据单因素分析的结果,在年龄、肿瘤直径、肌瘤数量和术后GnRH-a治疗方面,组间比较,差异均有统计学意义(均P <0. 05)。多因素Logistic回归分析结果显示,年龄低、肌瘤直径小、肌瘤数量多发和术后未进行GnRH-a治疗是导致子宫肌瘤剔除术后患者复发的危险因素,组间比较,差异均有统计学意义(均P <0. 05)。结论年龄、直径、肌瘤数量多发以及术后未进行GnRH-a治疗是导致子宫肌瘤剔除术后患者复发的危险因素,针对子宫肌瘤剔除术患者,术后给予GnRH-a治疗能够有效控制肌瘤复发,预防效果好,值得临床推广。

Objective To investigate the factors influencing the recurrence of uterine fibroids and to analyze the preventive effectiveness of gonadotropin-releasing agonists(GnRH-a).Methods A total of211 patients who underwent myomectomy at First Affiliated Hospital of Air Force Military Medical University from January 2015 to January 2016 were enrolled in the study.The patients were followed up and divided into a recurrent group and a control group according to whether recurrence occurred.Univariate analysis and multivariate logistic regression analysis were used for analysis of clinical data on uterine fibroid recurrence.Results After follow-up of 3 years,recurrence occurred in 63 patients(29.9%).According to the results of univariate analysis,the difference was statistically significant in age,tumor diameter,the number of fibroids,and postoperative management with GnRH-a between the groups(all P<0.05).According to the results of multivariate logistic regression analysis,your age,small-diameter fibroids,multiple fibroids,and no postoperative GnRH-a treatment were risk factors for recurrence after myomectomy.Conclusion Less than age 40,small diameter,multiple-fibroids,and no postoperative GnRH-a treatment are risk factors for recurrence after myomectomy.For patients undergoing myomectomy,GnRH can effectively control the recurrence,the prevention effectiveness is good,and it is worthy of clinical promotion.