子宫腺肌病腹腔镜术后复发影响因素及预测指标探讨  

Analysis of the influencing factors of the recurrence of adenomyosis of patients after laparoscopic surgery and discussion of the predictive indexes for the recurrence of adenomyosis

作　　者：赵震敏 徐沁 周丽[2] ZHAO Zhenmin;XU Qin;ZHOU Li(The Fourth Clinical School of Medicine,Zhejiang University of Traditional Chinese Medicine Hangzhou,Zhejiang Province,310000;Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine,Hangzhou,Zhejiang Province)

机构地区：[1]浙江中医药大学第四临床医学院,杭州310000 [2]浙江大学医学院附属杭州市第一人民医院

出　　处：《中国计划生育学杂志》2023年第7期1670-1674,共5页Chinese Journal of Family Planning

摘　　要：目的:观察子宫腺肌病(AM)腹腔镜术后复发影响因素及其预测。方法:回顾性分析2018年9月—2020年9月在本院行腹腔镜AM病灶切除术患者98例临床资料,随访2年术后复发情况。logistic多因素回归分析AM腹腔镜术后复发影响因素,应用受试者工作特征(ROC)曲线分析独立危险因素对AM腹腔镜术后复发的预测效能。结果:98例中AM腹腔镜术后2年复发17例,复发率为17.4%;单因素分析,患者年龄、痛经VAS评分、子宫体积、AM病灶类型、术后应用GnRH-a与术后复发有关(P<0.05);多因素分析显示,年龄<35岁、痛经VAS评分≥7分、子宫体积≥200 cm~3均为AM腹腔镜术后复发独立危险因素(P<0.05);AM病灶类型、术后应用GnRH-a非术后复发独立危险因素(P>0.05)。ROC曲线分析,年龄、痛经VAS评分、子宫体积均对AM腹腔镜术后复发有一定预测价值,曲线下面积分别为0.632、0.655、0.682。结论:年龄轻、痛经VAS评分高、子宫体积大均为AM腹腔镜术后复发影响因素,且对术后复发有一定预测价值,但术后应用GnRH-a对复发未见影响。临床可据此制定针对预防措施。Objective:To observe the influencing factors of the recurrence of adenomyosis(AM)of patients after laparoscopic surgery,and to discuss the predictive indexes for the recurrence of AM.Methods:The clinical data of 98patients who had accepted laparoscopic AM focus resection in hospital from September 2018to September 2020were analyzed retrospectively,and the recurrence of AM of these patients was observed in 2years of follow up after the operation.Multivariate logistic regression was used to analyze the influencing factors of the AM recurrence of these patients.The efficacy of the influencing factors of the patients for predicting their postoperative AM recurrence was analyzed by receiver operator characteristic(ROC)curve.Results:Among 98patients,there were 17cases with the recurred AM within 2years after laparoscopic AM surgery,and the recurrence rate was 17.4%.Univariate analysis showed that the age,the dysmenorrhea VAS score,the uterine volume,the AM lesion type,and the postoperative GnRH-a used of the patients were correlated with their postoperative AM recurrence(P<0.05).Multivariate analysis showed that the age<35years old,the VAS score≥7points,and the uterine volume≥200cm3 of the patients were all the independent risk factors for their AM recurrence(P<0.05).The AM lesion type and the postoperative GnRH-a used of the patients were non-independent risk factors for their postoperative recurrence(P>0.05).ROC curve analysis showed that age,the dysmenorrhea VAS score,and the uterine volume of the patients had certain predictive values for their AM recurrence after laparoscopic surgery,and the area under the curve of which were 0.632,0.655,and 0.682,respectively.Conclusion:The juvenility,the high dysmenorrhea VAS score,and the large uterine volume of the patients are all the influence factors of their AM recurrence after laparoscopic surgery,and which have certain predictive values for the AM recurrence.However,the postoperative GnRH-aapplication has no influent on the AM recurrence of the patients.So the target

关 键 词：子宫腺肌病 腹腔镜术 复发 影响因素 预测 

分 类 号：R713.4[医药卫生—妇产科学]