子宫内膜息肉患病高危因素分析
发布时间：2018-12-14 17:47
【摘要】：[目的]通过对子宫内膜息肉(EPs)患者的回顾性分析研究,探讨子宫内膜息肉发病的相关高危因素,为子宫内膜息肉的一级预防及早期防治提供临床依据。[方法]选取2014年9月至2016年9月就诊于昆明市延安医院妇科,经阴道超声检查考虑子宫内膜息肉行宫腔镜下子宫内膜息肉摘除术及诊断性刮宫术患者603例,进行回顾性分析,术后病检确诊为子宫内膜息肉的415例患者纳入病例组,术后病检诊断为非子宫内膜息肉良性的188例患者纳入对照组。统计患者所有临床资料,包括年龄、生育史、绝经与否、绝经年限、妇科合并症(子宫腺肌症、子宫肌瘤、子宫内膜异位症、宫颈息肉、息肉复发)、避孕情况(具有子宫内避孕装置、口服避孕药)、内科合并症(高血压、糖尿病、高脂血症、肥胖、免疫系统疾病)等情况。采用SPSS 22.0软件进行数据处理,计数资料采用独立样本X2检验,计量资料采用独立样本t检验,多因素病因分析采用二元Logistic回归分析。[结果]①年龄分布:EPs多发于30-49岁妇女,绝经后EPs的发病率降低。病例组415例,平均年龄41.34±8.59岁,其中绝经患者30例,平均绝经年限7.23士5.84年;对照组188例,平均年龄43.21±10.65岁,其中绝经患者38例,平均绝经年限6.24±6.76年。②临床表现:病例组222例(53.49%)患者无明显临床症状,193例(46.51%) 伴有相应临床症状;对照组85例(45.21%)患者无明显临床症状,103例(54.79%)伴有相应临床症状。③单因素分析结果显示:年龄、宫颈息肉、既往患有子宫内膜息肉、高血压、糖尿病、炎症、肥胖(P0.05,差异有统计学意义)是子宫内膜息肉发病的危险因素,绝经、患有免疫系统疾病(P0.05,差异有统计学意义)是子宫内膜息肉的保护因素。④进行多因素Logistic回归分析,高血压(OR 为 3.798, 95%CI 为 1.401 ～10.294, P0.01 )、宫颈息肉(OR 为 2.226,95%CI为1.039～4.768, P0.05)是子宫内膜息肉患病的相关危险因素,绝经(OR为0.311, 95%CI为0.163-0.593, P0.01)是子宫内膜息肉患病的保护因素。[结论]子宫内膜息肉好于30-49岁妇女,绝经后EPs的发病率降低,53.49%患者无明显临床症状,有症状的子宫内膜息肉患者常伴有月经的改变;经阴道超声对诊断子宫内膜息肉有较高的准确率,可应用于EPs疾病的初筛。高血压、宫颈息肉是子宫内膜息肉患病的相关危险因素,绝经是子宫内膜息肉患病的保护因素。年龄、不孕、子宫腺肌症、子宫肌瘤、子宫内膜异位症、息肉复发、糖尿病、高脂血症、肥胖、具有子宫内避孕装置(普通子宫内避孕装置,除外LNG-IUS)、子宫内膜炎症是子宫内膜息肉发病的可能危险因素,下一步将扩大样本量,进行前瞻性的研究,以明确子宫内膜息肉患病的危险因素。
[Abstract]:[objective] to study the risk factors of endometrial polyps in patients with (EPs), and to provide clinical basis for primary prevention and early prevention of endometrial polyps. [methods] 603 patients with endometrial polyps undergoing hysteroscopy and hysteroscopic curettage were selected from September 2014 to September 2016 in Yan'an Hospital of Kunming City. 415 cases of endometrial polyps diagnosed by postoperative pathological examination were included in the case group, and 188 cases of benign non-endometrial polyps were included in the control group. All clinical data including age, reproductive history, menopause, gynecological complications (adenomyosis, uterine leiomyoma, endometriosis, cervical polyp, polyp recurrence), Contraception (with intrauterine devices, oral contraceptive), medical complications (hypertension, diabetes, hyperlipidemia, obesity, immune system diseases) and so on. The data were processed by SPSS 22.0 software. The counting data were analyzed by independent sample X 2 test, the measurement data by independent sample t test, and the multifactor etiology analysis by binary Logistic regression analysis. [results] 1 Age distribution: EPs mainly occurred in 30-49 years old women, the incidence of EPs decreased after menopause. There were 415 cases in the case group with an average age of 41.34 卤8.59 years. Among them, 30 cases were postmenopausal patients with an average menopausal age of 7.23 卤5.84 years. 188 cases (mean age 43.21 卤10.65 years) in the control group, 38 cases were menopausal patients, and the mean menopausal age was 6.24 卤6.76 years. 2 Clinical manifestations: 222 cases (53.49%) in the case group had no obvious clinical symptoms. 193 cases (46.51%) were accompanied with corresponding clinical symptoms. In the control group, 85 cases (45.21%) had no obvious clinical symptoms, 103 cases (54.79%) had corresponding clinical symptoms. 3 the results of univariate analysis showed that: age, cervical polyps, previous endometrial polyps, hypertension, diabetes mellitus. Inflammation, obesity (P0.05, the difference is statistically significant) is a risk factor for the development of endometrial polyps, menopause, with immune system diseases (P0.05, P0.05. The difference was statistically significant. (4) Multivariate Logistic regression analysis showed that hypertension (OR = 3.798, 95%CI = 1.401 ~ 10.294, P0.01). Cervix polyp (OR = 2.226) (CI = 1.039 ~ 4.768, P0.05) was a risk factor for endometrial polyps, and menopause (OR = 0.311, 95%CI = 0.163-0.593). P0.01) is a protective factor for endometrial polyps. [conclusion] endometrial polyps are better than women aged 30-49 years. The incidence of EPs in postmenopausal women is lower, 53.49% of them have no obvious clinical symptoms, and the patients with symptomatic endometrial polyps often have menstrual changes. Transvaginal ultrasound has a high accuracy in the diagnosis of endometrial polyps and can be used in the screening of EPs disease. Hypertension and cervical polyps are risk factors for endometrial polyps and menopause is the protective factor for endometrial polyps. Age, infertility, adenomyosis, uterine leiomyoma, endometriosis, recurrence of polyps, diabetes, hyperlipidemia, obesity, having an intrauterine contraceptive device (other than LNG-IUS), Endometrial inflammation is a possible risk factor for the development of endometrial polyps. The next step is to expand the sample size and carry out prospective studies to identify the risk factors of endometrial polyps.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.74
本文编号：2379048
[Abstract]:[objective] to study the risk factors of endometrial polyps in patients with (EPs), and to provide clinical basis for primary prevention and early prevention of endometrial polyps. [methods] 603 patients with endometrial polyps undergoing hysteroscopy and hysteroscopic curettage were selected from September 2014 to September 2016 in Yan'an Hospital of Kunming City. 415 cases of endometrial polyps diagnosed by postoperative pathological examination were included in the case group, and 188 cases of benign non-endometrial polyps were included in the control group. All clinical data including age, reproductive history, menopause, gynecological complications (adenomyosis, uterine leiomyoma, endometriosis, cervical polyp, polyp recurrence), Contraception (with intrauterine devices, oral contraceptive), medical complications (hypertension, diabetes, hyperlipidemia, obesity, immune system diseases) and so on. The data were processed by SPSS 22.0 software. The counting data were analyzed by independent sample X 2 test, the measurement data by independent sample t test, and the multifactor etiology analysis by binary Logistic regression analysis. [results] 1 Age distribution: EPs mainly occurred in 30-49 years old women, the incidence of EPs decreased after menopause. There were 415 cases in the case group with an average age of 41.34 卤8.59 years. Among them, 30 cases were postmenopausal patients with an average menopausal age of 7.23 卤5.84 years. 188 cases (mean age 43.21 卤10.65 years) in the control group, 38 cases were menopausal patients, and the mean menopausal age was 6.24 卤6.76 years. 2 Clinical manifestations: 222 cases (53.49%) in the case group had no obvious clinical symptoms. 193 cases (46.51%) were accompanied with corresponding clinical symptoms. In the control group, 85 cases (45.21%) had no obvious clinical symptoms, 103 cases (54.79%) had corresponding clinical symptoms. 3 the results of univariate analysis showed that: age, cervical polyps, previous endometrial polyps, hypertension, diabetes mellitus. Inflammation, obesity (P0.05, the difference is statistically significant) is a risk factor for the development of endometrial polyps, menopause, with immune system diseases (P0.05, P0.05. The difference was statistically significant. (4) Multivariate Logistic regression analysis showed that hypertension (OR = 3.798, 95%CI = 1.401 ~ 10.294, P0.01). Cervix polyp (OR = 2.226) (CI = 1.039 ~ 4.768, P0.05) was a risk factor for endometrial polyps, and menopause (OR = 0.311, 95%CI = 0.163-0.593). P0.01) is a protective factor for endometrial polyps. [conclusion] endometrial polyps are better than women aged 30-49 years. The incidence of EPs in postmenopausal women is lower, 53.49% of them have no obvious clinical symptoms, and the patients with symptomatic endometrial polyps often have menstrual changes. Transvaginal ultrasound has a high accuracy in the diagnosis of endometrial polyps and can be used in the screening of EPs disease. Hypertension and cervical polyps are risk factors for endometrial polyps and menopause is the protective factor for endometrial polyps. Age, infertility, adenomyosis, uterine leiomyoma, endometriosis, recurrence of polyps, diabetes, hyperlipidemia, obesity, having an intrauterine contraceptive device (other than LNG-IUS), Endometrial inflammation is a possible risk factor for the development of endometrial polyps. The next step is to expand the sample size and carry out prospective studies to identify the risk factors of endometrial polyps.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.74
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