剖宫产术后腹壁切口子宫内膜异位症的临床观察

Clinical Observation of Abdominal Wall Incision Endometriosis after Cesarean Section

目的:探讨剖宫产术后腹壁切口子宫内膜异位症的发病率、发病机制、诊断、预防和治疗方法。方法:分析我院经手术及病理确诊的腹壁切口子宫内膜异位症患者26例临床资料。结果:腹壁子宫内膜异位症患者有明确的剖宫产史以及较典型的临床表现,通过术后病理检查可确诊;本组26例患者病灶均为一次手术切除,术后切口甲级愈合,病理检查见异位的子宫内膜腺体及间质,腺体分化良好;随访12个月～5年,无1例复发和恶变。结论:手术切除是目前为止唯一有效的治疗腹壁切口子宫内膜异位症的方法。故腹壁切口子宫内膜异位症的患者应尽早手术,切除范围要充分;另外于剖宫产术中保护腹壁切口以免子宫内膜种植,为本症预防的关键。

Objective： To investigate the incidence, pathogenesis, diagnosis, prevention and treatment of abdominal wall incision endometriosis after cesarean section.Methods：The clinical data of 26 patients who were diagnosed as abdominal wall incision endometriosis through operation and pathological method in our hospital were analyzed.Results：The patients with abdominal wall incision endometriosis had prominent cesarean section history and more typical clinical manifestations, and can be diagnosed by pathological examination after operation; the lesions of 26 patients in this group were cut in one time, the postoperative wound healing achieved Grade A, and ectopic endometrial glands and stroma can be seen through pathological check with excellent gland differentiation; the patients were followed up for 12 months to 5 years with no recurrence and malignant transformation. Conclusions：Resection is the only effective treatment so far for treating abdominal wall incision endometriosis. Therefore, patients with abdominal wall incision endometriosis should accept operation as early as possible, and the incision range should be sufficient, in addition, the abdominal wall incision should be protected in cesarean section to avoid planting of the endometrium, and it is the key to disease prevention.