卵巢子宫内膜异位囊肿发病相关因素调查

发布时间：2018-07-05 18:27

本文选题：卵巢 + 子宫内膜异位症　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的:子宫内膜异位症（下列简单称为内异症)在育龄期妇女中的发病率有着显著的上涨趋势，有“现代病”之称，其中卵巢子宫内膜异位症约占80％[1]。内异症是一种良性疾病，但与入侵、种植、复发性等恶性行为相符，是一种广泛的疾病,致病因素复杂。卵巢子宫内膜异位症的生长为一种病理性生长，如卵巢子宫内膜异位症的囊肿继续增大，粘连牢固，可发生继发性感染以及恶性变，其恶变率小于1%。因此，本病的预防远胜于医治。鉴于本病的发病机制尚不十分明了，分析卵巢子宫内膜异位症的发病因素有着重要的临床价值。本研究对影响卵巢子宫内膜异位症的众多因素进行分析，寻找相关的危险因素，以期对卵巢子宫内膜异位症的一级预防提供一些理论依据。方法：采用病例对照研究方法，收集2008年1月1日至2013年12月31日期间我院妇产科卵巢子宫内膜异位症患者共286例，同时选取同期本科卵巢良性肿瘤（巧囊除外）81例，平均年龄分别为（32.68±6.78）岁、（34.73±6.42）岁。以上所有患者均经术后病理确诊。采用Excel2007建立数据库，采用SPSS19.0软件进行数据的管理和统计。使用方法：将卵巢子宫内膜异位症发病的相关因素，行组间单因素对照，选用X2检验，将有统计学意义的单因素经由多因素Logistic多元回归模型进行分析，寻找卵巢子宫内膜异位症的相关因素（计算OR值及95％可信区间），P＜0.05有统计学意义。结果：1.从年龄上看，卵巢子宫内膜异位症的年龄分布有一定的规律性，患病高峰为30-34岁，占病例组总数的22.03％，好发于育龄期，25-44岁之间总计占77.97％。2.通过单因素分析显示文化程度、职业、月经初潮年龄、月经周期、经期、月经量、分娩次数、人工流产次数、子宫腺肌病、宫内节育器这几项因素与卵巢子宫内膜异位症的发生有关（P值均小于0.05）。3.多因素条件Logistic回归分析后的结果显示文化程度、行经天数、原发性痛经、人流次数的OR值均1，结合各因素的回归系数β0（正相关），说明这4项是OEM发病的危险因素。初潮年龄、宫内节育器的OR值均1，结合回归系数β 0（负相关），说明这2项因素是OEM的保护因素。职业、月经周期、分娩次数、子宫腺肌病在单因素分析中显示与OEM的发病相关，，但经过多因素调整后显示它们与OEM的发生并无关联，这些因素与OEM的关系有待进一步研究。结论：1.卵巢子宫内膜异位症好发于育龄期，25-44岁之间总计占77.97％。2.卵巢子宫内膜异位症是一个多因素综合作用的结果，其危险因素有文化程度、经期、原发性痛经、人流次数。3.初次来月经的年龄、宫内节育器是卵巢子宫内膜异位症的保护性因素。
[Abstract]:Objective: the incidence of endometriosis (hereinafter referred to as endometriosis) in women of childbearing age has a significant upward trend, known as "modern disease", in which ovarian endometriosis accounted for about 80% [1]. Endometriosis is a benign disease, but consistent with invasion, planting, recurrence and other malignant behavior, is a widespread disease, the pathogenic factors are complex. The growth of ovarian endometriosis is a kind of pathological growth, such as the cyst of ovarian endometriosis continues to increase, adherent firm, can occur secondary infection and malignant change, its malignant rate is less than 1. Therefore, the prevention of the disease is far better than cure. Since the pathogenesis of this disease is not very clear, the analysis of the pathogenesis of ovarian endometriosis has important clinical value. In order to provide some theoretical basis for primary prevention of ovarian endometriosis, this study analyzed many factors affecting ovarian endometriosis and looked for related risk factors. Methods: from January 1, 2008 to December 31, 2013, a total of 286 patients with ovarian endometriosis in our hospital from January 1, 2008 to December 31, 2013 were collected, and 81 cases of benign ovarian tumors (except for cysts) were selected from the same period. The average age was (32.68 卤6.78) years, (34.73 卤6.42) years. All of the above patients were confirmed by postoperative pathology. Using Excel 2007 to establish the database, SPSS 19.0 software for data management and statistics. Methods: the related factors of ovarian endometriosis were analyzed by multivariate logistic regression model. To find out the related factors of ovarian endometriosis (calculated OR value and 95% confidence interval) (P < 0.05) was statistically significant. The result is 1: 1. In terms of age, the age distribution of ovarian endometriosis has a certain regularity, the peak of the disease is 30-34 years old, accounting for 22.03 of the total number of cases, the predilection occurred between 25 and 44 years of reproductive age accounted for a total of 77.97.2. Univariate analysis showed that education level, occupation, menarche age, menstrual cycle, menstrual period, menstrual volume, number of deliveries, number of induced abortions, adenomyosis of uterus, These factors were related to the occurrence of ovarian endometriosis (P < 0.05) .3. The results of multivariate conditional logistic regression analysis showed that the OR values of education, menstrual days, primary dysmenorrhea and abortion times were all 1. Combined with the regression coefficient 尾 0 (positive correlation) of all factors, the 4 items were the risk factors of OEM. The age of menarche and the OR of IUD were all 1. The regression coefficient 尾 0 (negative correlation) showed that these two factors were the protective factors of OEM. Occupation, menstrual cycle, delivery times, adenomyosis were associated with OEM in univariate analysis, but after multivariate adjustment, they were not related to OEM, and the relationship between these factors and OEM should be further studied. Conclusion 1. Ovarian endometriosis occurred between 25 and 44 years of reproductive age, accounting for 77.97 and 2. 7%. Ovarian endometriosis is the result of multiple factors, its risk factors are education, menstruation, primary dysmenorrhea, abortion times. At the age of first menstruation, IUD is a protective factor for ovarian endometriosis.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.71

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