摘要
目的分析子宫内膜异位症术后的复发率及复发相关因素。方法对210例经术后病检证实为子宫内膜异位症的患者进行5年随访，将其中复发64例患者的临床资料进行回顾性分析，明确其病理类型和分期，了解手术经过和术后患者疼痛症状，行妇科内诊、超声检查和测定血CA125，分析复发与病理类型、分期、年龄、术式、术后是否用药情况的关系。结果手术累积复发率为30．48％，术后5年内患者每年复发的概率几乎相同。行保守性手术、半根治性手术和根治性手术的复发率分别为41．41％、26．25％和6．45％，经两两比较有显著性差异（X2分别为4．49、13．04、5．33，均P〈0．05）。在临床病理类型中，深部结节型、混合型（包括两种或两种以上临床病理类型）患者的复发率分别为47．83％、40．00％，明显高于卵巢型的24．06％（X2分别为5．55、4．23，均P〈0．05），复发率与临床病理类型有一定的关系。复发率随着子宫内膜异位症分期的增高而增加，Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的复发率分别为17．95％、20．63％、36．05％、59．09％，Ⅰ期与Ⅲ、Ⅳ期患者的复发率经比较差异均有统计学意义（X2分别为4．15、10．80，均P〈0．05）；Ⅱ期与Ⅲ期、Ⅳ期患者复发率比较差异有统计学意义（X2分别为4．15、11．36，均P〈0．05）。年龄≤24岁患者有1例复发，复发率为5．26％，与其余4个年龄段（25—29、30～34、35—39、≥40岁的复发率分别为32．50％、32．76％、32．84％和34．62％）比较差异有统计学意义（X2分别为3．88、4．29、5．74、3．91，均P〈0．05），年龄与复发有一定的关系。加用米非司酮治疗患者的复发率为26．62％，未用药患者的复发率为46．34％，两者比较差异有统计学意义（X2=6．05，P〈0．01），术后用药与复发有一定的关系。结论盆腔子宫内膜异位症是一
Objective To investigate recurrence rate and its related factors of patients with endometriosis. Methods 210 women whose diagnosis were confirmed as endometriosis after surgery were followed-up for 5 years. The clinical data of 64 relapsed women were analyzed retrospectively. Their pathological types and stages were determined. The surgical procedures and aching symptoms were inquired. The women received gynecological examination , ultrasonography and serum CA125 detection and relationships between recurrence and pathological type, stage of endometriosis, age of the patient, surgical method, and medication were analyzed. Results The cumulative postoperative recurrence rate was 30.48%. The probability of relapse in each year within five years after operation was almost the same. The cumulative recurrence rates of conservative operation, semi-radical operation and radical operation were 41.41%, 26. 25% and 6.45% respectively. By comparisons of each two operation methods there were significant differences （X2 = 4.49, 13.04 and 5.33 respectively, all P 〈 0.05 ）. In clinicopathological types, the relapse rates of patients with deep nodular and mixed types （ including two and above types） of endometriosis were 47.83% and 40.00%, which were significantly higher than that of patients with ovarian type （24.06%） （X2 = 5.55 and 4.23 respectively, both P 〈 0.05 ）, suggesting that the relapse rate was related to clinicopathological types of endometriosis. The recurrence rate increased with progression in stages of endometriosis. The relapse rates of patients with endometriosis at stage Ⅰ ,Ⅱ, Ⅲ and Ⅳ were 17.95% , 20.63%, 36.05% and 59.09% respectively. As compared the recurrence rate of patients with endometriosis at stage I with that of patients with endometriosis at stageⅢ or Ⅳ, there were statistically significant differences （X2 =4.15 and 10.80 respectively, both P 〈0.05）. So did between stage Ⅱ and stage Ⅲ or stage IV （X2 =4.15 and 11.36 respectively, both P 〈 0.05 ）. Only
出处
《中国妇幼健康研究》
2009年第2期178-180,184,共4页
Chinese Journal of Woman and Child Health Research
