237例卵巢子宫内膜异位囊肿复发因素分析.docVIP

　　237例卵巢子宫内膜异位囊肿复发因素分析 【摘要】 　　目的 探讨不同类型手术后卵巢子宫内膜异位囊肿的预后及复发因素。方法 回顾性分析237例经手术治疗并经病理检查确诊为卵巢子宫内膜异位囊肿患者的临床资料，随访观察15项指标。结果 (1)术后总复发率为31.2％。开腹根治组的术后复发率与其他各组比较差异均有统计学意义(P＜0.05)；(2)各种术后主观症状评分差异无统计学意义(P＞0.05)；(3)复发组与未复发组在术前孕次、术前产次、术后产次、卵巢子宫内膜异位囊肿直径、有无内异症手术史、有无后穹隆结节、术中应用防黏剂与否7方面差异有统计学意义(P＜0.05)；(4)经多因素Cox风险回归分析最终确定，复发的保护性因素为术前产次、术后产次、术中防黏剂治疗；危险性因素为肿瘤直径、后穹窿有痛性结节、内异症手术史。结论 术前术后产次、术中应用防黏剂治疗为内异症术后复发的保护性因素，卵巢子宫内膜异位囊肿直径、后穹窿触痛结节和既往有内异症手术史是复发的危险性因素。 【关键词】 子宫内膜异位症；手术治疗；预后；复发因素 　　Abstract:Objective To discuss the prognosis and related factors of endometriosis cyst of ovary after different types of surgery treatment. Methods The clinical information of 237 patients etriosis cyst of ovary ination. The recurrent rate of different types of operation and variables ultivariate COX regression analyses ed to determine the related recurrence factors of endometriosis. Results (1) The total recurrence rate after operation ptom of life quality among different types of operation (P＞0.05). (3) There es of gravidity before operation,times of delivery before operation, postoperative delivery,the diameter of cyst, history of endometriosis operation tenderness nodules at culdesac, side of endometrioma, using anticonglutination medicineetc betultivariate COX regression analyses shoes of delivery before operation, postoperative delivery and using anticonglutination medicine and that risk factors eter of cyst tenderness nodules at culdesac, left side of endometrioma and the history of endometriosis operation. Conclusion The protective factors of recurrence of endometriosis include times of delivery before operation, postoperative delivery and using anticonglutination medicine.The risk factors of endometriosis include diameter of cyst, tenderness nodules at culdesac, left side of endometrioma and the history of endometriosis operation. 　　Key etriosis；surgery treatment；prognosis；related factors of recurrence 　　子宫内膜异位症(endometriosis，EMS)的复发率很高，不同手术后复发率各家报道不一，1％～62％不等［1］，手术或药物治疗效果有限。本研究通过回顾分析EMS患者的临床