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目的探讨子宫肌瘤切除术后足月妊娠与肌瘤复发的关系。方法对2007年5月-2009年9月于新疆医科大学第一附属医院接受子宫肌瘤切除术且年龄<40岁的患者84例进行随访。结果 84例患者中9例(10.7%)失访,75例患者平均随访(3.0±0.7)a。24例子宫肌瘤复发,复发率为32.0%。无复发生存曲线提示术后无足月妊娠史的患者子宫肌瘤复发率高于术后有足月妊娠史的患者(P=0.02)。有足月妊娠史的患者复发肌瘤最大直径明显大于无足月妊娠史的患者(P=0.001)。多因素分析结果示子宫肌瘤数目是复发的独立危险因素(P=0.003)。结论肌瘤数目是复发的最重要因素,妊娠分娩不增加复发,但是足月妊娠会增加复发肌瘤的直径,可能会使复发患者更倾向于需要接受进一步的治疗。
Objective To investigate the relationship between full-term pregnancy and recurrence of fibroids after myomectomy. Methods From May 2007 to September 2009, 84 patients with uterine fibroid resection at the First Affiliated Hospital of Xinjiang Medical University who were younger than 40 years were followed up. Results Of the 84 patients, 9 (10.7%) were lost to follow-up, and 75 patients were followed-up for an average of (3.0 ± 0.7) years. 24 cases of uterine fibroids recurrence, the recurrence rate was 32.0%. The recurrence-free survival curve suggests that the recurrence rate of uterine fibroids was higher in patients who did not have a full-term pregnancy than those who had a full-term pregnancy after surgery (P=0.02). Patients with a full-term pregnancy had a significantly larger recurrent leiomyoma size than those without a full-term pregnancy (P=0.001). Multivariate analysis showed that the number of uterine fibroids was an independent risk factor for recurrence (P=0.003). Conclusion The number of fibroids is the most important factor for recurrence. Pregnancy delivery does not increase recurrence, but full-term pregnancy increases the diameter of recurrent fibroids, which may make relapse patients more inclined to need further treatment.