子宫肌瘤剔除术后复发危险因素的分析  

Risk Factors Related with Recurrence of Uterine Myoma after Myomectomy

作　　者：瞿红[1] 张震宇[1] 刘崇东[1] 郭淑丽[1] 李淑红[1] 

机构地区：[1]首都医科大学附属北京朝阳医院,北京100020

出　　处：《实用妇产科杂志》2007年第12期726-727,共2页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨子宫肌瘤剔除术后复发的危险因素。方法:对行子宫肌瘤剔除术的251例患者,进行定期随访并记录检查结果,分析定期随访并资料齐全的234例患者资料。结果:①两组患者共54例(23.1%,54/234)复发。腹腔镜组复发44例(24.2%,44/182),经腹手术组复发10例(19.2%,10/52),两组复发率差异无显著性(P>0.05)。②单因素分析显示子宫大小、肌瘤大小和数目是复发的相关因素。Cox回归分析显示复发的3个相关危险因素为:肌瘤≥10 cm(P=0.004);多发肌瘤(P=0.001);肌壁间肌瘤(P=0.021)。复发患者中3例再次接受手术治疗(5.6%,3/54),2例行全子宫切除术,1例行肌瘤剔除术。结论:腹腔镜子宫肌瘤剔除术后不增加复发机会,复发的3个危险因素是肌瘤≥10 cm、多发肌瘤以及肌壁间肌瘤。Objective： To investigate the risk factors related with recurrence of uterine myomas after myomectomy.Methods：We prospectively analyzed 251 cases of uterine myoma from May.2000 to Jau.2005 and followed up regularly after operation. Results：17 patients of total 251 cases （6.77%, 17/251 ） were lost during follow-up. The data showed 54 cases recurred（23.1%,54/234）, 44 cases（24.2%,44/182） in Laproscopic myomectomy（LM） group and 10 cases（19.2%,10/52） in Abdominal myomectomy（AM） group, no significant difference between them. Single factor analysis showed the factors related to recurrence were volume of uterine, loca- tion, size and number of myomas. Cox regression analysis suggested that the predictive factors for myoma relapse are diameter of myomas≥10 cm （ P= 0.004, RR=2.504, 95%CI 1.626,6.896）, multiple myomas（ P= 0,001, RR=3.349, 95%CI 1.626,6.896）, and intramural myomas（ P= 0.021, RR= 2.103, 95%CI 1.114,3.639）. 3 recurred patients underwent second-operation （5.6%, 3/54, 2 total hysterectomy and 1 myomectomy） .Conclusions：Recurrence rate of myomas between LM and AM is not significant. The predict factors are size and number of myomas. Patients with multiple or larger myomas（diameter≥10 cm） prone to recur.

关 键 词：子宫肌瘤 肌瘤剔除术 复发 

分 类 号：R713.4[医药卫生—妇产科学]