CAJ | 학술논문

目的：探讨卵巢子宫内膜异位症术后复发的相关因素。方法对2010年1月至2012年6月由安阳市肿瘤医院手术治疗的146例卵巢子宫内膜内异症患者随访1年，其中复发49例，将患者的临床资料进行分析。对患者的年龄、职业、不孕史、慢性腹痛史、盆腔炎史、盆腔手术史、痛经程度、手术方式、手术范围、术后是否用药、术后孕育史、CA125、CA199、镜下病理类型等与复发的关系做Logistic回归分析。结果单因素Logistic回归显示与复发有关的因素包括不孕史、慢性腹痛史、痛经程度、盆腔炎史、手术方式、卵巢子宫内膜异位症的分型、初潮年龄、CA199（ P﹤0.01），将上述因素纳入多因素Logistic回归分析，结果证实不孕史、卵巢子宫内膜异位症分型、手术方式与术后短期复发有关（ P﹤0.05）。结论既往不孕史、Ⅱ型卵巢子宫内膜异位症以及腹腔镜手术是卵巢子宫内膜异位症术后复发的相对独立危险因素。应根据患者的临床特点、孕育要求和经济能力，制定合理的个体化临床治疗方案。
목적：탐토란소자궁내막이위증술후복발적상관인소。방법대2010년1월지2012년6월유안양시종류의원수술치료적146례란소자궁내막내이증환자수방1년，기중복발49례，장환자적림상자료진행분석。대환자적년령、직업、불잉사、만성복통사、분강염사、분강수술사、통경정도、수술방식、수술범위、술후시부용약、술후잉육사、CA125、CA199、경하병리류형등여복발적관계주Logistic회귀분석。결과단인소Logistic회귀현시여복발유관적인소포괄불잉사、만성복통사、통경정도、분강염사、수술방식、란소자궁내막이위증적분형、초조년령、CA199（ P﹤0.01），장상술인소납입다인소Logistic회귀분석，결과증실불잉사、란소자궁내막이위증분형、수술방식여술후단기복발유관（ P﹤0.05）。결론기왕불잉사、Ⅱ형란소자궁내막이위증이급복강경수술시란소자궁내막이위증술후복발적상대독립위험인소。응근거환자적림상특점、잉육요구화경제능력，제정합리적개체화림상치료방안。
Objective To investigate the relative factors of postoperative recurrence of ovarian endometriosis. Methods From Jan 2010 to Jun 2012,146 patients with ovarian endometrisosis under-went surgery in tumor hospital of Anyang were followed up for 1 year,and 49 cases had recurrence. The clinical data of the patients were analyzed. The relationship between recurrence and patient’s age,occu-pation,history of infertility,chronic abdominal pain history,history of pelvic inflammatory disease,his-tory of pelvic operation,the degree of dysmenorrhea,operation mode,operation scope,postoperative medication,postoperative pregnancy,CA125,CA199,microscopic pathologic types were analyzed by Logistic regression analysis. Results Single factor Logistic regression showed that the factors related to the recurrence including history of infertility,history of chronic abdominal pain,dysmenorrhea, pelvic inflammatory disease,operation mode,ovarian endometriosis type,age of menarche,CA199 ( P﹤0. 01 ). The above factors were brought into the multi-factor logistic regression analysis,and the results confirmed that the history of infertility,ovarian endometriosis classification,operation method was correlated with the short-term postoperative recurrence of ovarian endometriosis( P ﹤0. 05 ). Conclusions Previous history of infertility,type Ⅱ of ovarian endometriosis and laparoscopic operation are the relatively independent risk factors of ovarian endometriosis recurrence. Reasonable indi-vidualized treatment plan should be made according to the clinical characteristics of patients,gestation re-quirements and economic capacity.