摘要
目的探讨45岁及以上未绝经多发子宫肌瘤患者行子宫肌瘤剔除术的可行性,分析子宫肌瘤剔除术后肌瘤残留、复发情况及相关危险因素。方法回顾性分析2013年2月至2018年11月于首都医科大学附属北京妇产医院妇科微创中心行开腹或腹腔镜下子宫肌瘤剔除术治疗的86例多发子宫肌瘤患者的临床资料及随访资料。分析影响术后子宫肌瘤残留及复发的相关因素。结果子宫肌瘤剔除术后平均随访36(18,62)个月,肌瘤残留率为34.88%(30/86),肌瘤复发率为46.51%(40/86)。多因素Logistic回归分析显示,肌瘤数目是影响子宫肌瘤剔除术后肌瘤残留、肌瘤复发的危险因素(OR=1.065,95%CI 1.002~1.132,P=0.043;OR=1.100,95%CI 1.006~1.202,P=0.036)。肌瘤残留及复发患者随访期间肌瘤增长不明显,均未行二次手术治疗。结论肌瘤数目是子宫肌瘤剔除术后残留和复发的危险因素。对于45岁及以上未绝经多发子宫肌瘤要求保留子宫患者,子宫肌瘤剔除术是一种可行的手术方式。
Objective To explore the feasibility of myomectomy for premenopausal patients aged 45 years and older with multiple uterine myoma after myomectomy,and analyze the postoperative residue and recurrence,and related risk factors in the patients. Methods The clinical data and follow-up results of 86 women undergoing transabdominal or laparoscopic myomectomy in Department of Gynecology Minimal Invasive Center,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from Feb. 2013 to Nov. 2018 were retrospectively analyzed. The influencing factors of residue and recurrence were analyzed. Results The average follow-up period was 36( 18,62) months. The residual rate of myoma was34. 88%( 30/86),and the recurrence rate of myoma was 46. 51%( 40/86). Multivariate Logistic regression analysis showed that the number of myoma was a risk factor for myoma residue and recurrence after myomectomy( OR = 1. 065,95% CI1. 002-1. 132,P = 0. 043;OR = 1. 100,95% CI 1. 006-1. 202,P = 0. 036). During the follow-up period,the growth of myoma was not obvious in patients with residual and recurrent myoma,and no second operation was peformed. Conclusion The number of myomas is the risk factor of postoperative residue and recurrence. Myomectomy is a feasible surgical method for premenopausal patients aged 45 years and older with multiple uterine myoma requiring to retain uterus.
作者
张博
李斯静
张露
孟戈
ZHANG Bo;LI Sijing;ZHANG Lu;MENG Ge(Department of Gynecology Minimal Invasive Center,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,China;Center of Hysteroscope,Fuxing Hospital,Capital Medical University,Beijing 100038,China)
出处
《医学综述》
CAS
2021年第10期2031-2034,2039,共5页
Medical Recapitulate
