子宫肌壁间平滑肌瘤行肌瘤剔除术后复发相关危险因素分析

目的:探讨子宫肌壁间平滑肌瘤行肌瘤剔除术后复发的相关危险因素。方法:以我院2010 年1月至 2015 年12月期间316例子宫肌壁间平滑肌瘤患者为研究对象，收集其临床资料，包括手术时年龄，体重指数，初潮年龄，绝经状态，手术方式，肌瘤数目及大小，术后病理。分析患者术后复发的相关因素。结果:术后共复发64/316例，复发率为20.25%。年龄，BMI，有无合并糖尿病，初潮年龄，肌瘤家族史，术后妊娠状态与肌瘤术后复发无显著关联（P值均大于0.05）。多因素Logistic 回归分析显示:多发肌瘤（风险比2.112），未绝经（风险比1.987），肌瘤最大直径≥5 cm（风险比1.722），不典型肌瘤（风险比2.436），腹腔镜手术（风险比1.694）是肌瘤术后复发的独立性危险因素（P值均小于0.05）。结论:对于肌壁间平滑肌瘤而言，多发肌瘤，未绝经，肌瘤最大直径≥5 cm，不典型肌瘤，腹腔镜手术是肌瘤剔除术后复发的独立性危险因素。在临床中进行术前评估复发风险时应考虑这些因素。

Risk factors of recurrence of 316 patients with uterine myoma after myomectomy

Objective:In this study，we report our retrospective investigation of risk factors of recurrence of 316 uterine myoma after myomectomy.Methods:316 patients with uterine myoma from January 2010 to December 2015 underwent myomectomy in our hospital were enrolled.Clinicopathologic data including age，body mass index (BMI)，number of myomas，size of largest leiomyoma，family history of uterine myoma，surgical procedures and delivery after myomectomy rate were collected.Related risk factors of recurrence were investigated.Results:The cumulative recurrence rates were 64/316(20.25%).The clinical features such as age，family history，BMI，diabetes mellitus，the menarche age and delivery after myomectomy were not related to the recurrence rate(all P>0.05).Multiple logistic regression analysis revealed that multiple myoma (OR=2.112)，premenopausal (OR=1.987)，uterine myoma size≥5 cm (OR=1.722)，uterine atypical myoma (OR=2.436)，laparoscopic myomectomy (OR=1.694) significantly contributed to the postoperative recurrence rate(all P<0.05).Conclusion:Multiple myoma，premenopausal，uterine myoma size≥5 cm，uterine atypical myoma，laparoscopic myomectomy are independently risk factors for recurrence of uterine myoma after myomectomy.When we evaluate the recurrence before myomectomy，these risk factors should be considered.