卵巢子宫内膜异位囊肿术后复发的临床特点与影响因素分析

陆志灵; 唐菲; 李婉晴; 何晔; 郭培培; 叶伟; 吴荣; 魏兆莲

doi:10.19538/j.fk2026010120

PDF(1018 KB)

中国实用妇科与产科杂志 ›› 2026, Vol. 42 ›› Issue (1) : 95-99. DOI: 10.19538/j.fk2026010120

论著

卵巢子宫内膜异位囊肿术后复发的临床特点与影响因素分析

陆志灵 ¹^,² ,
唐菲 ¹ ,
李婉晴 ¹ ,
何晔 ¹ ,
郭培培 ¹ ,
叶伟 ¹ ,
吴荣 ¹ ,
魏兆莲 ¹

作者信息 +

Analysis of clinical characteristics and influencing factors of postoperative recurrence of ovarian endometriosis

LU Zhi-ling ¹^,² ,
TANG Fei ¹ ,
LI Wan-qing ¹ ,
HE Ye ¹ ,
GUO Pei-pei ¹ ,
Ye Wei ¹ ,
WU Rong ¹ ,
WEI Zhao-lian ¹

Author information +

文章历史 +

摘要

目的探讨卵巢子宫内膜异位囊肿（OMA）术后复发特点及影响因素。方法基于回顾性分析2018年1月至2023年1月在安徽医科大学第一附属手术治疗的475例OMA，其中术后复发227例为研究组，术后未复发248例为对照组。结果合并子宫肌瘤[比值比（OR）=1.823，95% 置信区间（CI） 1.072~3.100]、双侧OMA（OR=1.968，95%CI 1.132~3.421）、伴随临床症状（OR=2.491，95%CI 1.553~3.995）、月经分泌期手术（OR=1.930，95%CI 1.253~2.973）、子宫内膜异位症手术分期高（OR=1.588，95%CI 1.204~2.095）及原发囊肿大（OR=1.139，95%CI 1.027~1.263）增加术后复发的概率；高血红蛋白（Hb）（OR=0.982，95%CI 0.967~0.999）、术后药物治疗（OR=0.220，95%CI 0.126~0.384）及术后生育（OR=0.507，95%CI 0.290~0.887）降低术后复发的概率。原发单侧术后易复发于原发侧，原发双侧术后易复发于左侧。结论合并子宫肌瘤、双侧OMA、伴随临床症状、月经分泌期手术、子宫内膜异位症手术分期高、原发囊肿大是OMA术后复发的独立危险因素。高Hb、术后药物治疗及术后生育是术后复发的保护因素。原发性OMA与复发性OMA的侧别分布有一定相关性。

Abstract

Objective To analyze the characteristics and influencing factors of postoperative recurrence of ovarian endometrioma. Methods A retrospective analysis was performed on 475 patients with OMA who were treated in the First Affiliated Hospital of Anhui Medical University from January 2018 to January 2023, with 227 patients with postoperative recurrence in the study group and 248 with no recurrence in the control group. Results Combination with uterine fibroids （OR=1.823，95%CI 1.072-3.100），bilateral OMA （OR=1.968，95%CI 1.132-3.421），being accompanied by clinical symptoms （OR=2.491，95%CI 1.553-3.995），surgery during menstrual secretion （OR=1.930，95%CI 1.253-2.973），high surgical stage （OR=1.588，95%CI 1.204-2.095）and large primary cyst （OR=1.139，95%CI 1.027-1.263）increased the probability of postoperative recurrence. High Hb （OR=0.982，95%CI 0.967-0.999），postoperative drug therapy （OR=0.220，95%CI 0.126-0.384） and postoperative childbirth（OR=0.507，95%CI 0.290-0.887）reduced the probability of postoperative recurrence. The postoperative recurrence of unilateral primary OMA was more likely to occur on the primary side，and the recurrence of bilateral primary OMA was more likely to be on the left side. Conclusions Combination with uterine fibroids，bilateral OMA，being accompanied by clinical symptoms，surgery during menstrual secretion，high surgical stage，and large primary cyst are independent risk factors for postoperative recurrence of OMA. High Hb，postoperative drug therapy and postoperative childbirth are protective factors for postoperative recurrence. There is a certain correlation between primary OMA and recurrent OMA concerning the lateral distribution.

导出引用

陆志灵, 唐菲, 李婉晴, 等. 卵巢子宫内膜异位囊肿术后复发的临床特点与影响因素分析[J]. 中国实用妇科与产科杂志. 2026, 42(1): 95-99 https://doi.org/10.19538/j.fk2026010120

LU Zhi-ling, TANG Fei, LI Wan-qing, et al. Analysis of clinical characteristics and influencing factors of postoperative recurrence of ovarian endometriosis[J]. Chinese Journal of Practical Gynecology and Obstetrics. 2026, 42(1): 95-99 https://doi.org/10.19538/j.fk2026010120

中图分类号： R711.71

参考文献

列表( 原文顺序 | 文献年度倒序 | 文中引用次数倒序 ) 可视化分析

[1]	冷金花, 史精华. 重视子宫内膜异位症患者生育力保护[J]. 中国实用妇科与产科杂志, 2024, 40(5):481-484. DOI:10.19538/j.fk2024050101. 本文引用 [1]

[2]	Chiu CC, Hsu TF, Jiang LY, et al. Maintenance therapy for preventing endometrioma recurrence after endometriosis resection surgery - a systematic review and network meta-analysis[J]. J Minim Invasive Gynecol, 2022, 29(5):602-612. DOI:10.1016/j.jmig.2021.11.024. 本文引用 [1]

[3]	Guo SW, Martin DC. The perioperative period: a critical yet neglected time window for reducing the recurrence risk of endometriosis?[J]. Hum Reprod, 2019, 34(10):1858-1865. DOI:10.1093/humrep/dez187. 本文引用 [1]

[4]	陈春林, 段慧. 应客观评价微无创技术在妇产科疾病诊治中的应用[J]. 中国实用妇科与产科杂志, 2024, 40(9):913-917. DOI:10.19538/j.fk2024090114. 本文引用 [2]

[5]	Yang F, Liu B, Xu L, et al. Age at surgery and recurrence of ovarian endometrioma after conservative surgery: a meta-analysis including 3125 patients[J]. Arch Gynecol Obstet, 2020, 302(1):23-30. DOI:10.1007/s00404-020-05586-3. 本文引用 [1]

[6]	Gallagher CS, Mäkinen N, Harris HR, et al. Genome-wide association and epidemiological analyses reveal common genetic origins between uterine leiomyomata and endometriosis[J]. Nat Commun, 2019, 10(1):4857. DOI:10.1038/s41467-019-12536-4. 本文引用 [1]

[7]	徐萍, 张信美. 有生育要求的子宫内膜异位症患者术后管理[J]. 中国实用妇科与产科杂志, 2024, 40(5):497-500. DOI:10.19538/j.fk2024050105. 本文引用 [1]

[8]	Matalliotaki C, Matalliotakis M, Zervou MI, et al. Epidemiological aspects of the outcomes from the treatment of endometriosis:Experience from two different geographical areas[J]. Exp Ther Med, 2020, 19(2):1079-1083. DOI:10.3892/etm.2019.8296. 本文引用 [1]

[9]	Schweppe KW, Ring D. Peritoneal defects and the development of endometriosis in relation to the timing of endoscopic surgery during the menstrual cycle[J]. Fertil Steril, 2002, 78(4):763-766. DOI:10.1016/s0015-0282(02)03431-3. 本文引用 [1]

[10]	张欢, 李永红, 刘云兰, 等. 不同手术时机对腹腔镜卵巢囊肿剥离术后患者卵巢功能的影响[J]. 白求恩医学杂志, 2020, 18(5):471-473.DOI:10.16485/j.issn.2095-7858.2020.05.024. 本文引用 [1]

[11]	朱晴晴, 吴明富, 冯严支, 等. Ⅲ/Ⅳ期卵巢子宫内膜异位症保守手术后复发相关因素分析[J]. 华中科技大学学报(医学版), 2021, 50(1):90-93.DOI:10.3870/j.issn.1672-0741.2021.01.017. 本文引用 [1]

[12]	彭超, 周应芳. 复发性卵巢子宫内膜异位症的管理[J]. 中国实用妇科与产科杂志, 2022, 38(5):491-495.DOI:10.19538/j.fk2022050104. 本文引用 [1]

[13]	彭超, 黄艳, 周应芳. 子宫内膜异位症的早期诊断和治疗[J]. 中国实用妇科与产科杂志, 2024, 40 (5): 485-489. DOI:10.19538/j.fk2024050102. 本文引用 [1]

[14]	Ghezzi F, Beretta P, Franchi M, et al. Recurrence of ovarian endometriosis and anatomical location of the primary lesion[J]. Fertil Steril, 2001, 75(1):136-140. DOI:10.1016/s0015-0282(00)01664-2. 本文引用 [1]

[15]	Vercellini P, Busacca M, Aimi G, et al. Lateral distribution of recurrent ovarian endometriotic cysts[J]. Fertil Steril, 2002, 77(4):848-849.DOI:10.1016/s0015-0282(01)03239-3. 本文引用 [1]