Research Of Correlative Factors Influencing Recurrence Of Endometriosis

ObjectiveTo investigate and study recurrent rate of endometriosis and toanalysis correlative factors and treatment of the patients of The SecondClinic Hospital of Jilin University who have had endometriosis and whohave been underwent surgery.MethodsA case control study. Adopt the1:1proportion of case-control studymethod; The clinical records of the120patients of The Second ClinicHospital of Jilin University who have had endometriosis and who have beenunderwent surgery and then the patients were followed up. Choose from60cases of recurrence as study group, and use60cases of no recurrence asthe control group. Adopt the Excel2003to establish a database and analyzewith the SPSS19.0statistical software.Results1. From the age point of view, endometriosis age distribution has certainregularity. It recurs largely from41to50years old. There was nostatistical meaning between EM staging and age differences accordingto the analysis of variance (P＞0.05).2. Both of the groups have been operated by laparoscopy or laparotomy.The rate of laparoscopy of study group was lower than the rate ofcontrol group. There was no statistical meaning between operationstyle according to the analysis of variance (P＞0.05).3. The rate of dysmenorrhea history of study group was76.67%, and therate of control group was53.33%. The rate of dysmenorrhea history ofstudy group was obviously higher than the rate of control group （P<0.05）.4. According to the pathological type, all cases were divided to threegroups:a group: left cyst, b: right cyst, c: both cyst. There was nostatistical meaning between the pathological type according to theanalysis of variance (P＞0.05).5. There were32（53.33%） cases of I-II stage and28（46.67%）cases ofIII-IV stage of study group. There were43（73.33%） cases of I-II stageand17（246.67%）cases of III-IV stage of control group. The higher theclinical stage of the endometriosis, the higher the recurrent rate(P<0.05).6.48（80.00%） patients of study group had tenderness nodules atcul-de-sac，and31（51.67%）patients of control group had tendernessnodules at cul-de-sac. The rate of tenderness nodules at cul-de-sacof study group was obviously higher than the rate of control group(P<0.05).7. The patients of post-operative treated by GnRH-a were named A group.The patients treated by gestrinone named B group. The patients withno adjuvant therapy were named C group. The rate of C group of studygroup was obviously higher than the rate of A and B group, and therewas a statistical meaning for difference of recurrence rate(P<0.05).But there was no statistical difference among group A and B(P＞0.05).8. There were24（40.00%） cases of study group had been sufferedintrauterine operations and there were29（48.33%） cases of controlgroup had been suffered intrauterine operations. There was nostatistical meaning between intrauterine operation according to theanalysis of variance (P＞0.05).9. According to the associated gynecology diseases, the rate of pelvicinflammation history and adenomyosis of study group was higher thanthe rate of control group, and there was a statistical meaning for difference of recurrence rate(P<0.05).10.There were5（8.33%） cases of post-operative gravidity of study groupand there were16（26.67%）cases of post-operative gravidity of controlgroup. There was a statistical meaning between had been post-operativegravidity according to the analysis of variance (P<0.05).Conclusion1. Endometriosis recurs largely from36to45years old. Patients who arein this age stage should be followed up continuously after operation.2. Through statistical analysis we found that related factors forrecurrence ofendometriosis were: dysmenorrhea history, staging of disease,post-operative gravidity, post-operative adjuvant therapy, tendernessnodules at cul-de-sac, pelvic inflammation history and adenomyosis.3. The five risk factors of recurrence of endometriosis are dysmenorrheahistory, staging of disease, tenderness nodules at cul-de-sac, pelvicinflammation history and adenomyosis. Post-operative gravidity andpost-operative adjuvant therapy may be protective factors of recurrenceof endometriosis. The patients who are eager to pregnant, the activetreatment should be taken after surgery.4. The endometriosis patients should have adjuvant therapy afterconservative surgery. Both of GnRH-a and gestrinone can reduce therecurrence of endometriosis obviously. But there is no significantdifference between the two medicine.5. Individualized therapeutic regimen should be made in treatment ofendometriosis according to: dysmenorrhea history, staging of disease,post-operative gravidity, post-operative adjuvant therapy, tendernessnodules at cul-de-sac, pelvic inflammation history and adenomyosis. Therecurrent rate could be reduced and the interval of recurrence couldbe prolonged using ovarian function inhibiting drugs for a short time post-operation.