论文部分内容阅读
目的 确定与子宫内膜异位症 (内异症 )保守性手术后病变复发的相关因素。方法对 2 85例保守性手术治疗并经病理证实的内异症患者观察并随访 36个月 ,观察患者年龄、发病年龄、术前孕次、术前产次、后穹窿痛性结节、子宫活动度、血清CA12 5、既往内异症手术史、腹腔镜手术史、内异症病变侧别、术中和术后美国生育学会修订的内异症分期标准 (r AFS ,1985 )评分、术后孕激素治疗 6个月、术后枸橼酸氯米芬 (其他名称 :克罗米酚 )促排卵治疗、术后孕次、术后产次等 31项指标 ,随访中记录病变复发情况及复发时间。应用SPSS软件行COX回归风险分析筛查复发的相关因素。结果共有 83例 (2 9 1% ,83/2 85 )患者复发 ,每年复发例数、复发率和累积复发率为 ,第 1年 4 1例 ,14 4 % (41/2 85 )和 14 4 % (41/2 85 ) ;第 2年 30例 ,10 5 % (30 /2 85 )和 2 4 9% (71/2 85 ) ;第 3年 12例 ,4 2 % (12 /2 85 )和 2 9 1% (83/2 85 )。经单变量分析 ,危险性相关因素为既往有内异症手术史 (OR值为 13 6 30 ,P <0 0 1)、后穹窿有痛性结节 (OR值 6 133,P <0 0 1)、术后应用枸橼酸氯米芬促排卵治疗 (OR值 5 173,P <0 0 1)、左侧盆腔病变 (OR值 4 5 0 3,P <0 0 1)、双侧盆腔病变 (OR值 3 70 9,P <0 0 5 )和术后r AF
Objective To determine the related factors of recurrence after conservative surgery with endometriosis (endometriosis). Methods A total of 2 85 cases of conservative surgical treatment and endometriosis confirmed by pathology were followed up for 36 months. The age, onset age, preoperative pregnancy, preoperative delivery, post-cavity fornix nodules, uterus Activity, serum CA12 5, history of previous endometriosis surgery, history of laparoscopy, endometriosis lesion side, intraoperative and postoperative American Fertility Society revised endometriosis staging criteria (r AFS, 1985) score, surgery Post-progestin treatment for 6 months, postoperative clomiphene citrate (other name: Clomiphene) ovulation induction, postoperative pregnancy time, postoperative delivery and other 31 indicators, follow-up record of the recurrence of lesions and Recurrence time. The application of SPSS software COX regression analysis of risk factors for relapse screening. Results A total of 83 patients (291%, 83/285) had recurrences. The number of recurrent cases, the relapse rate and the cumulative recurrence rate were 41 cases in year 1, 14 4% (41/2 85) and 14 4 (41/285) in the second year, 30 cases in the second year, 10 5% (30/2 85) and 249% (71/2 85) in the second year, 12 cases in the third year and 42% (12/2 85) And 291% (83/2 85) respectively. Univariate analysis showed that the risk factors were previous history of endometriosis surgery (OR 13 6 30, P 0 01) and posterior fornix nodules (OR 6 133, P 0 01 ), Postoperative clomipine citrate ovulation therapy (OR 5 173, P 0 01), left pelvic lesions (OR 4550, P 0 01), bilateral pelvic lesions (OR 3 70 9, P 0 05) and postoperative r AF