摘要
目的 对子宫内膜异位症的相关危险因素进行分析.方法 选取2009年1月-2013年12月在浙江萧山医院妇科手术治疗的子宫内膜异位症术后2年内复发的患者82例（观察组）,同时选取同期手术治疗的子宫内膜异位症术后2年内未复发的患者82例（对照组）,收集上述患者的临床资料,采用单因素与多因素Logistic回归分析方法,分析可能影响患者术后复发的相关因素.结果 经单因素分析术前痛经、手术分期、后穹窿触痛结节、术后药物[促性腺激素释放激素类似物（GnRH-a）]治疗、合并盆腔炎、合并子宫腺肌病及术后妊娠与子宫内膜异位症复发相关（P＜0.05）.Logisitic回归分析法进行分析显示：术前痛经、手术分期（Ⅲ～Ⅳ期）、后穹窿触痛结节、合并盆腔炎、合并子宫腺肌病5个因素均是子宫内膜异位症复发的危险因素,而术后药物（GnRH-a）治疗及术后妊娠2个因素均是子宫内膜异位症复发的保护因素.结论 通过对有痛经史、手术分期（Ⅲ～Ⅳ期）、后穹窿触痛结节及合并盆腔炎及子宫腺肌病等高危子宫内膜异位症复发患者行手术治疗时,应选用创伤小、能彻底清除病灶的个体化治疗方案,术后药物治疗和术后妊娠可以减少复发.
Objective To analyze the associated risk factors for the analysis of relapse of endometriosis. Methods From January 2009 to December 2013, the clinical data of patients with （ 82 cases, observation group） or without （ 82 cases, the control group） the recurrence of endometriosis during 2 years after the surgical treatment in our hospital were analyzed retrospectively. The univariate and multiple Logistic regressions were used to predict the potential risk factors of the recurrence of endometriosis. Results The univariate analysis showed that preoperative symptoms, surgical staging, palpable nodules in the posterior fornix, drug treatment, postoperative pelvic inflammation, the combining uterine adenomyosis and postoperative pregnancy were all associated with endometriosis recurrence（ all P 〈 0.05 ）. The multiple Logisitic regression analysis showed that preoperative dysmenorrhea, surgical staging （Ⅲ- Ⅳ ） , tender fixed nodule in the posterior fornix, pelvic inflammation and the combining uterine adenomyosis were all risk factors for the recurrence of endometriosis, and postoperative drug treatment and postoperative pregnancy were two protective factors of endometriosis recurrence. Conclusion For the patients with the history of menstrual cramps, surgical staging（ Ⅲ - Ⅳ ） ,tender fixed nodule in the posterior fornix,complicating pelvic inflammation and adenomyosis, we should choose the individualized treatment that can remove the focus thoroughly but with less trauma. The postoperative drug treatment and postoperative pregnancy will reduce the postoperative recurrence of endometriosis.
出处
《中华全科医学》
2015年第10期1653-1654,1660,共3页
Chinese Journal of General Practice
