子宫内膜异位症的术后复发机制及危险因素

子宫内膜异位症（endometriosis，EMs）是育龄期女性常见疾病，手术是EMs可靠、有效的治疗手段，但术后高复发率是临床棘手的问题。目前其复发机制不明确，高危因素尚存在争议。可能与在位内膜及经血逆流有关，同时与激素依赖有关，此外，异位子宫内膜干细胞的持续存在可能在EMs术后的复发中起重要作用。影响EMs复发的因素较多，其中手术的彻底性是降低术后复发的重要保证。因此，为降低EMs术后复发率，不应过多依赖术后辅助药物治疗，而应在不损伤正常器官的前提下尽可能清除病灶，减少残留病灶及致病因子。

Mechanism and Risk Factors for Recurrence of Endometriosis after Surgery

Endometriosis is a common disease in women of reproductive age. The laparoscopic treatment is reliable and effective. However, the frustrating problem is the high rate of recurrence after surgery. The mechanism of recurrence, as well as those risk factors, is still unclear. It may be related to the retrograde menstruation, the estrogen-dependent mechanism and the ectopic endometial stem cells. There are many risk factors of recurrence after surgery, the key factor being whether to operate thoroughly. Thus ,for reducing the postoperative recurrence, we should not rely too much on postoperative auxiliary drug therapy. We should eliminate the residual lesions as far as possible with respect to the surgery safety.