宫颈上皮内瘤变患者宫颈锥切术后复发影响因素分析  

Analysis of influencing factors of recurrence after conization of cervix in patients with cervical intraepithelial neoplasia

作　　者：刘红[1] 曲雪青 蒋业忠[1] 吴大保[2] Liu Hong;Qu Xueqing;Jiang Yezhong;Wu Dabao(Department of Obstetrics and Gynecology,Ma'anshan People's Hospital,Anhui,Ma'anshan 243011,China;Department of Obstetrics and Gynecology,Anhui Provincial Hospital,Hefei 230001,China)

机构地区：[1]马鞍山市人民医院妇产科,安徽马鞍山243011 [2]安徽省立医院妇产科,合肥230001

出　　处：《中国医学前沿杂志（电子版）》2020年第6期57-60,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：安徽省第一批科技计划项目(1501041141)。

摘　　要：目的分析宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)患者宫颈锥切术后复发的影响因素。方法回顾性分析2016年4月至2018年4月于马鞍山市人民医院行宫颈锥切术的80例CIN患者的临床资料,按照术后是否复发将其分为复发组(23例)和未复发组(57例),收集患者的临床资料进行单因素分析和多因素Logistic回归分析,明确CIN患者宫颈锥切术后复发的影响因素。结果 80例患者中复发23例,复发率为28.75%。复发组年龄>35岁、绝经、孕次>2次、产次>2次、性伴侣≥2人、术前人乳头状瘤病毒(human papilloma virus,HPV)阳性、手术切缘阳性、腺体受累患者占比均显著高于未复发组(均P<0.05)。多因素Logistic回归分析显示:年龄≤35岁、孕次≤2次、产次≤2次、性伴侣<2人均为CIN患者术后复发的保护因素(OR=0.100、0.028、0.206、0.093,均P<0.05);绝经、术前HPV阳性、手术切缘阳性、腺体受累均为CIN患者术后复发的独立危险因素(OR=4.949、6.628、59.067、4.829,均P<0.05)。结论 CIN患者宫颈锥切术后复发与年龄、绝经、孕次、产次、性伴侣、术前HPV阳性、手术切缘阳性、腺体受累有关,应针对患者不同特点进行干预,以降低术后复发率。Objective To investigate the influencing factors of recurrence after conization of cervix in patients with cervical intraepithelial neoplasia(CIN).Method Clinical data of 80 patients with CIN who underwent conization of cervix from April 2016 to April 2018 in Ma'anshan People's Hospital were retrospectively analyzed,according to whether recurrent after operation,they were divided into recurrence group(n=23)and non-recurrence group(n=57).The clinical data of patients were collected for univariate analysis and multivariate Logistic regression analysis to determine the influencing factors of recurrence after conization of cervix in patients with CIN.Result There were 23 cases of recurrence in 80 patients,the recurrence rate was 28.75%.The proportion of patients with age>35 years,menopause,gravidity>2 times,parity>2 times,sexual partners≥2,positive preoperative human papilloma virus(HPV),positive surgical margin and glandular involvement in recurrence group were significantly higher than those in non-recurrence group(all P<005).Multivariate Logistic regression analysis showed that:age≤35 years old,gravidity≤2 times,parity≤2 times,and sexual partner<2 were protective factors for postoperative recurrence in patients with CIN(OR=0.100,0.028,0.206,0.093,all P<0.05).Menopause,positive preoperative HPV,positive surgical margin and glandular involvement were all independent risk factors for postoperative recurrence in patients with CIN(OR=4.949,6.628,59.067,4.829,all P<0.05).Conclusion The recurrence of CIN patients after conization of cervix is related to age,menopause,gravidity,parity,sexual partner,positive preoperative HPV,positive surgical margin and glandular involvement.Intervention should be carried out according to the different characteristics of the patients in order to reduce the postoperative recurrence rate.

关 键 词：宫颈上皮内瘤变 宫颈锥切术 复发 影响因素 

分 类 号：R737.33[医药卫生—肿瘤]