本文選題：卵巢 + 子宮內(nèi)膜異位癥�。� 參考：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的:子宮內(nèi)膜異位癥（下列簡(jiǎn)單稱為內(nèi)異癥)在育齡期婦女中的發(fā)病率有著顯著的上漲趨勢(shì)，有“現(xiàn)代病”之稱，其中卵巢子宮內(nèi)膜異位癥約占80％[1]。內(nèi)異癥是一種良性疾病，但與入侵、種植、復(fù)發(fā)性等惡性行為相符，是一種廣泛的疾病,致病因素復(fù)雜。卵巢子宮內(nèi)膜異位癥的生長(zhǎng)為一種病理性生長(zhǎng)，如卵巢子宮內(nèi)膜異位癥的囊腫繼續(xù)增大，粘連牢固，可發(fā)生繼發(fā)性感染以及惡性變，其惡變率小于1%。因此，本病的預(yù)防遠(yuǎn)勝于醫(yī)治。鑒于本病的發(fā)病機(jī)制尚不十分明了，分析卵巢子宮內(nèi)膜異位癥的發(fā)病因素有著重要的臨床價(jià)值。本研究對(duì)影響卵巢子宮內(nèi)膜異位癥的眾多因素進(jìn)行分析，尋找相關(guān)的危險(xiǎn)因素，以期對(duì)卵巢子宮內(nèi)膜異位癥的一級(jí)預(yù)防提供一些理論依據(jù)。 方法：采用病例對(duì)照研究方法，收集2008年1月1日至2013年12月31日期間我院婦產(chǎn)科卵巢子宮內(nèi)膜異位癥患者共286例，同時(shí)選取同期本科卵巢良性腫瘤（巧囊除外）81例，平均年齡分別為（32.68±6.78）歲、（34.73±6.42）歲。以上所有患者均經(jīng)術(shù)后病理確診。采用Excel2007建立數(shù)據(jù)庫(kù)，采用SPSS19.0軟件進(jìn)行數(shù)據(jù)的管理和統(tǒng)計(jì)。使用方法：將卵巢子宮內(nèi)膜異位癥發(fā)病的相關(guān)因素，行組間單因素對(duì)照，選用X2檢驗(yàn)，將有統(tǒng)計(jì)學(xué)意義的單因素經(jīng)由多因素Logistic多元回歸模型進(jìn)行分析，尋找卵巢子宮內(nèi)膜異位癥的相關(guān)因素（計(jì)算OR值及95％可信區(qū)間），P＜0.05有統(tǒng)計(jì)學(xué)意義。 結(jié)果：1.從年齡上看，卵巢子宮內(nèi)膜異位癥的年齡分布有一定的規(guī)律性，患病高峰為30-34歲，占病例組總數(shù)的22.03％，好發(fā)于育齡期，25-44歲之間總計(jì)占77.97％。2.通過(guò)單因素分析顯示文化程度、職業(yè)、月經(jīng)初潮年齡、月經(jīng)周期、經(jīng)期、月經(jīng)量、分娩次數(shù)、人工流產(chǎn)次數(shù)、子宮腺肌病、宮內(nèi)節(jié)育器這幾項(xiàng)因素與卵巢子宮內(nèi)膜異位癥的發(fā)生有關(guān)（P值均小于0.05）。3.多因素條件Logistic回歸分析后的結(jié)果顯示文化程度、行經(jīng)天數(shù)、原發(fā)性痛經(jīng)、人流次數(shù)的OR值均1，結(jié)合各因素的回歸系數(shù)β0（正相關(guān)），說(shuō)明這4項(xiàng)是OEM發(fā)病的危險(xiǎn)因素。初潮年齡、宮內(nèi)節(jié)育器的OR值均1，結(jié)合回歸系數(shù)β 0（負(fù)相關(guān)），說(shuō)明這2項(xiàng)因素是OEM的保護(hù)因素。職業(yè)、月經(jīng)周期、分娩次數(shù)、子宮腺肌病在單因素分析中顯示與OEM的發(fā)病相關(guān)，，但經(jīng)過(guò)多因素調(diào)整后顯示它們與OEM的發(fā)生并無(wú)關(guān)聯(lián)，這些因素與OEM的關(guān)系有待進(jìn)一步研究。 結(jié)論：1.卵巢子宮內(nèi)膜異位癥好發(fā)于育齡期，25-44歲之間總計(jì)占77.97％。2.卵巢子宮內(nèi)膜異位癥是一個(gè)多因素綜合作用的結(jié)果，其危險(xiǎn)因素有文化程度、經(jīng)期、原發(fā)性痛經(jīng)、人流次數(shù)。3.初次來(lái)月經(jīng)的年齡、宮內(nèi)節(jié)育器是卵巢子宮內(nèi)膜異位癥的保護(hù)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 鹵6.78) years, (34.73 鹵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.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.71

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