复发子宫内膜异位症二次手术的临床特点  

Characteristics of recurrent endometriosis and second surgery

作　　者：潘宁萍[1] 吴婷婷[1] 胡长长 江秀秀[1] 吴瑞瑾[1] 

机构地区：[1]浙江大学医学院附属妇产科医院,杭州310000

出　　处：《现代妇产科进展》2017年第2期129-132,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨子宫内膜异位症(EMs)非根治术后复发并行二次手术患者的临床特点。方法:回顾分析2010年1月至2015年8月于浙江大学医学院附属妇产科医院行二次手术治疗的290例EMs复发患者的临床资料。结果:290例患者二次手术平均间隔为(5.96±3.38)年,初次手术年龄大、初次手术r-AFS分期越高的患者的两次手术间隔时间短(P<0.05),初次手术为半根治手术或单侧卵巢切除、术后有生育史的患者的两次手术间隔时间长(P<0.05)。有腺肌病史、初次手术r-AFS分期高的患者的复发分期明显高于无腺肌病史、初次手术r-AFS分期低者(P<0.05)。4.0%接受术后短期辅助药物治疗(≤6月)的患者1年内接受二次手术,12.2%未接受药物治疗的患者在1年内接受二次手术。结论:EMs初次手术分期高、有腺肌病史是复发的危险因素,初次保守手术单侧卵巢切除或者子宫切除及术后生育是延长二次手术间隔的保护因素。术后短期辅助药物治疗(≤6月)对降低术后1年内二次手术率有意义,但对延长远期二次手术间隔无明显意义。Objective： To evaluate characteristics of patients undergoing repetitive surgery for recurrent endometriosis.Methods： A retrospective study was performed on 290 patients who received second surgery for recurrent endometriosis between Jan. 2010 and Aug. 2015. Result： In the research of 290 patients,the average surgery interval was 5.96±3.30 years.The surgery interval was significantly shorter in elderly patients and in those with higher initial r-AFS stage（ P〈0.05）.While the surgery interval was longer in patients received hysterectomy or unilateral oophorectomy and in women who had postoperative pregnancy（ P〈0. 05）. Patients with adenomyosis or high initial r-AFS stage were more likely to have a high recurrent r-AFS stage（ P〈0.05）.Only 4.0% of patients who received short-term（ ≤6 months） postoperative medical treatment had the second surgery in one year,compared to 12.2% of patients who received no treatment.Conclusion： The adenomyosis and high initial r-AFS stage are risk factors for recurrence of endometriosis.Hysterectomy or unilateral oophorectomy and postoperative pregnancy are protective factors and prolong the surgery interval.A short-term（ ≤6 months） postoperative medical treatment could reduce second surgery in one year,however,there was no significant effect in reducing long-term second surgery.

关 键 词：子宫内膜异位症 复发 二次手术 临床特点 

分 类 号：R711.74[医药卫生—妇产科学]