宫腔镜下息肉电切术后子宫内膜息肉复发影响因素分析  

Analysis of the influencing factors of the endometrial polyp recurrence after hysteroscopic polypectomy

作　　者：麻婷 周怡 杨芳 刘瑾 MA Ting;ZHOU Yi;YANG Fang;LIU Jin(The Second Affiliated Hospital of Air Force Millitary Medical University,Xi'an,Shanxi Province,710038)

机构地区：[1]空军军医大学第二附属医院,西安710038

出　　处：《中国计划生育学杂志》2024年第12期2934-2938,2943,共6页Chinese Journal of Family Planning

摘　　要：目的:分析宫腔镜下子宫内膜息肉电切术后患者息肉复发影响因素。方法:回顾性纳入2021年1月-2022年12月本院择期行宫腔镜下息肉电切术的子宫内膜息肉患者253例临床资料,术后随访1年,调查术后1年内子宫内膜息肉复发情况,利用logistic回归分析模型对影响因素进行分析。结果:253例中单发性息肉占66.4%、多发性息肉占33.6%;手术治疗1年后57例息肉复发,复发率为22.5%。单因素分析显示,不同年龄、体质指数、合并不孕症、息肉数目、息肉最大径、术后并发症和术后处理措施的患者术后子宫内膜息肉复发情况存在差异(P<0.05);多因素logistic回归分析表明,患者年龄>35岁(OR=2.519)、合并不孕症(OR=3.102)、息肉数目为多发(OR=4.175)是影响子宫内膜息肉患者术后1年内复发的独立危险因素,而术后放置左炔诺酮宫内节育系统(OR=0.534)和口服屈螺酮炔雌醇片(Ⅱ)(OR=0.651)是息肉复发的独立保护因素(均P<0.05)。结论:宫腔镜电切术后子宫内膜息肉患者术后1年内息肉复发率较高,临床术前对年龄大、合并不孕症、息肉多发的患者给予评估干预,采用术后处理,以降低术后息肉复发风险。Objective:To analyze the influencing factors of the endometrial polyp recurrence of patients after hysteroscopic polypectomy.Methods:The clinical data of 253 patients with endometrial polyps who had undergone the elective hysteroscopic polypectomy in the hospital from January 2021 to December 2022 were analyzed retrospectively.These patients were followed up for 1 year after surgery,and the recurrence of the endometrial polyps of the patients within 1 year after surgery was investigated.Logistic regression analysis model was used to analyze the influencing factors of the recurrence of the endometrial polyps of the patients.Results:Among 253 patients,the rate of the patients with single polyps was accounted for 66.4%and the rate of the patients with multiple polyps was accounted for 33.6%.After 1 year of surgery,57 patients had the recurrence of the polyps,and with the recurrence rate of 22.5%.Univariate analysis showed that there were significant differences in the recurrence of endometrial polyps among the patients with different age,among the patients with different body mass index,between the patients with and without infertility,among the patients with different number of polyps,among the patients with different maximum diameter of polyps,among the patients with different postoperative complications and among the patients with different postoperative management measures(P<0.05).Multivariate logistic regression analysis showed that the age>35 years old(OR=2.519),the infertility(OR=3.102)the multiple polyps(OR=4.175)of the patients were the independent risk factors of their recurrence of endometrial polyps within 1 year after surgery,while the postoperative levonorgestrel intrauterine system inserted(OR=0.534)and the oral drospirenone and ethinylestradiol tablets(II)(OR=0.651)of the patients were the independent protective factors of their recurrence of endometrial polyps(all P<0.05).Conclusion:The recurrence rate of the endometrial polyps of the patients within 1 year after hysteroscopic polypectomy is higher.

关 键 词：子宫内膜息肉 宫腔镜下电切术 术后1年内复发 影响因素 

分 类 号：R713.4[医药卫生—妇产科学]