绝经期子宫肌瘤继续增长和子宫肌瘤剔除术后残留的高危因素分析
Analysis of High Risk Factors of Residual and Continue to Grow after Myomectomy in Menopause

目的：探究绝经期子宫肌瘤继续增长和子宫肌瘤剔除术后残留的高危因素，以期为临床上绝经期子宫肌瘤患者的治疗提供思路和理论依据。方法：收集597例绝经期患者，根据是否发生绝经后子宫肌瘤的增长，将患者分成继续增长组和非继续增长组，其中继续增长组患者54例，非继续增长组患者83例。其中54例绝经期子宫肌瘤继续增长患者选择子宫肌瘤剔除术。54例子宫肌瘤继续增长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，子宫组织的lncRNA表达。利用Logistic回归分析进行单因素和多因素分析。结果：入组的597例绝经期患者中，有54例子宫肌瘤患者出现绝经期后继续增长，绝经期后子宫肌瘤继续增长率为9.05%。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绝经期子宫肌瘤继续增长的高危因素(P < 0.05)。Logistic多因素分析结果显示，超重，子宫肌瘤数目 ≥ 5，病理类型是绝经期子宫肌瘤继续增长的高危因素(P < 0.05)。54例子宫肌瘤继续增长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绝经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，病理类型是绝经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绝经期子宫肌瘤继续增长和子宫肌瘤手术剔除术后残留的高危因素。
Objective: To explore the high-risk factors of continued growth of menopausal hysteromyoma and residual hysteromyoma after myomectomy, in order to provide ideas and theoretical basis for the clinical treatment of menopausal hysteromyoma patients. Methods: The 597 menopausal patients were collected. According to the growth of postmenopausal uterine fibroids, the patients were divided into continuous growth group and non continuous growth group, including 54 patients in continuous growth group and 83 patients in non continuous growth group. Among them, 54 patients with menopausal hysteromyoma continued to grow, 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 597 menopausal patients in the group, 54 patients with hysteromyoma continued to grow after menopause, and the continuous growth rate of hysteromyoma after menopause was 9.05%. 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 continued growth of menopausal hysteromyomas (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 continued growth of hysteromyomas in menopause (P < 0.05). The myomectomy was selected in 54 patients with continuous growth of hysteromyoma. 18 patients with hysteromyoma had