育龄期子宫肌瘤异常肥大和子宫肌瘤剔除术后残留的高危因素分析

Analysis of High Risk Factors of Excessive Hypertrophy of Uterine Leiomyoma and Residual after Myomectomy in Child-Bearing Period

摘要: 目的：探究育龄期子宫肌瘤异常肥大和子宫肌瘤剔除术后残留的高危因素，以期为临床上育龄期子宫肌瘤患者的治疗提供思路和理论依据。方法：收集331例育龄期患者，根据是否发生子宫肌瘤的异常肥大，将患者分成异常肥大组和非异常肥大组，其中异常肥大组患者54例，非异常肥大组患者277例。其中54例育龄期子宫肌瘤异常肥大患者选择子宫肌瘤剔除术。54例子宫肌瘤异常肥大的子宫肌瘤患者均选择子宫肌瘤剔除术，根据是否有残留分成残留组和非残留组，收集入组者的基准资料，包括年龄，体重指数，病理类型。利用Logistic回归分析进行单因素和多因素分析。结果：入组的331例育龄期患者中，有54例子宫肌瘤患者出现育龄期异常肥大，育龄期后子宫肌瘤异常肥大率为16.31%。单因素分析结果显示，超重，子宫肌瘤数目 ≥ 5个，最大肌瘤直径，富于细胞型子宫肌瘤是育龄期子宫肌瘤异常肥大的高危因素(P < 0.05)。Logistic多因素分析结果显示，超重，子宫肌瘤数目 ≥ 5，病理类型是育龄期子宫肌瘤异常肥大的高危因素(P < 0.05)。54例子宫肌瘤异常肥大患者选择子宫肌瘤剔除术，有18例子宫肌瘤患者出现术后残留，肌瘤术后残留率为33.33%。单因素分析结果显示，超重，子宫肌瘤数目 ≥ 5个，最大肌瘤直径，富于细胞型子宫肌瘤是育龄期子宫肌瘤手术剔除术后残留的高危因素(P < 0.05)。Logistic多因素分析结果显示，超重，子宫肌瘤数目 ≥ 5，病理类型是育龄期子宫肌瘤手术剔除术后残留的高危因素(P < 0.05)。结论：超重，子宫肌瘤数目 ≥ 5个，最大肌瘤直径，富于细胞型子宫肌瘤是育龄期子宫肌瘤异常肥大和子宫肌瘤手术剔除术后残留的高危因素。

Abstract: Objective: To explore the high-risk factors of excessive hypertrophy of hysteromyomas and residual hysteromyoma, in order to provide ideas and theoretical basis for the clinical treatment of hysteromyoma patients in child-bearing period. Methods: The 331 patients in child-bearing period were collected. According to the growth of uterine fibroids, the patients were divided into excessive hypertrophy and non-excessive hypertrophy, including 54 patients in excessive hypertrophy and 277 patients in non-excessive hypertrophy. Among them, 54 patients with hysteromyoma excessive hypertrophy, and hysteromyomectomy was selected. All 54 patients with uterine fibroids with continuous growth of uterine fibroids were selected for myomectomy. They were divided into the residual group and the non-residual group according to whether there was residual. The baseline data of the participants were collected, including age, the body mass index (BMI), pathological type. The Logistic regression analysis was used for univariate and multivariate analysis. Results: Among the 331 patients in child-bearing period in the group, 54 patients with hysteromyoma excessive hypertrophy, and the excessive hypertrophy rate of hysteromyoma was 16.31%. The univariate analysis showed that overweight, the number of hysteromyoma ≥ 5, the maximum diameter of hysteromyomas, cell-rich hysteromyomas were the high-risk factors for the excessive hypertrophy of hyster-omyomas in child-bearing period (P < 0.05). The results of logistic multivariate analysis showed that overweight, the number of hysteromyomas ≥ 5, pathological type were the high-risk factors for the excessive hypertrophy of hysteromyomas (P < 0.05). The myomectomy was selected in 54 patients with excessive hypertrophy of hysteromyoma. 18 patients with hysteromyoma had postoperative residue, and the residual rate of hysteromyoma was 33.33%. The univariate analysis showed that overweight, the number of hysteromyomas ≥ 5, the maximum diameter of hystero-myomas, cell-rich hysteromyomas were the high-risk factors for residual after surgical removal of hysteromyomas in child-bearing period (P < 0.05). The results of logistic multivariate analysis showed that overweight, the number of hysteromyomas ≥ 5, pathological type were the high-risk factors of residual after surgical removal of hysteromyomas in child-bearing period (P < 0.05). Con-clusion: The overweight, the number of hysteromyomas ≥ 5, the maximum diameter of hysteromyomas, cell-rich hysteromyomas are the high-risk factors for the continued growth of hysteromyomas and the residue after surgical removal of hysteromyomas.