摘要
目的探讨卵巢子宫内膜异位症复发的相关影响因素。方法选择我院2012年1月至2014年1月收治的卵巢子宫内膜异位症患者271例,根据随访期间是否复发分为复发组和未复发组,采用Cox单因素回归模型比较复发组与未复发组临床资料,进行多变量Cox风险回归分析。结果随访入组者共229例,采用Cox单因素回归模型分析,复发组较未复发组术时年龄小[(30.2±6.1)vs.(34.5±7.2)岁]、最大卵巢囊肿直径大[(6.8±2.4)vs.(5.5±2.7)cm]、rAFS评分高[(48.6±26.4)vs.(41.1±23.8)分]、术后受孕率低(12.1%vs.35.7%),差异均有统计学意义(P<0.05);复发组与未复发组在初潮年龄、体重指数、痛经、不孕、人流次数、疾病患侧、是否伴有粘连、道格拉斯腔封闭、合并腺肌症、合并子宫肌瘤、腹部手术史、手术途径、术后药物治疗等方面,差异无统计学意义(P>0.05);多变量Cox风险回归分析结果显示,术时年龄、rAFS评分、手术方式及术后受孕影响卵巢子宫内膜异位症术后复发,其中术时年龄大、半根治性手术及术后受孕是卵巢子宫内膜异位症术后复发的保护性因素,rAFS评分则是其复发的危险因素。结论患者术时年龄、rAFS评分、手术方式及术后受孕与卵巢子宫内膜异位症的复发相关。术时年龄大、rAFS评分低、半根治性手术及术后受孕的卵巢子宫内膜异位症患者,术后复发风险相对较低。
Objective： To analyze the factors related with the recurrence of ovarian endometriosis. Methods： A total of 271 patients with ovarian endometriosis were treated in our hospital from January 2012 to January 2014. The patients were divided into recurrence group and non-recurrence group by the recurrence status during follow-up period. The clinical data of two groups were analyzed by Cox single-factor model and Cox＇s proportional hazards model. Results： According to the results analyzed by Cox single-factor model, the age at surgery was significantly younger [（30.2±6.1）vs. （34.5 ±7.2）years]; the diameter of the largest ovarian cyst was significantly bigger [（6.8 ±2.4） vs. （5.5 ±- 2.7） cm]; the score of rAFS （Revised American Fertility Society）was significantly higher [（48. 6 ± 26.4） vs. （41.1 ± 23.8）] and the pregnancy rate after surgery was significantly lower（12.1% vs. 35.7%）in the patients of recurrence group compared with non- recurrence group （all P〈0. 05）. All the differences in menarche age,BMI,condition of dysmenorrheal andinfertility, times of induced abortion, disease affected site, adhesion, Douglas pouch obliteration, complicated with adenomyosis or fibroid,abdominal operation history, surgical approach and drug therapy after surgery were not significant （P〉0.05）. The results of Cox＇s proportional hazards model showed that the ages, scores of rAFS, surgicall procedure fertilizatior after surgery were independent factors for the recurrence of endometriosis postoperation. The older age at surgery, semi-radical surgical treatment and fertilization after surgery were protective factors. The score of rAFS was a risk factor. Conclusions： The recurrence of endometriosis was related to the ages, scores of rAFS, surgical procedures and fertilization after surgery of patients. The recurrence risk of ovarian endometriosis is lower in the patients with younger ages at surgery, lower rAFS scores, semi-radical surgical treatment and postoperative pregnan
出处
《生殖医学杂志》
CAS
2016年第5期439-443,共5页
Journal of Reproductive Medicine
