产后切口部位子宫内膜异位症的诊断与治疗

Diagnosis and treatment of postpartum incision endometriosis

目的 探讨产后切口部位子宫内膜异位症的临床特点及诊治方法.方法 对84例产后切口部位子宫内膜异位症患者的临床资料进行回顾性分析.结果 84例患者中79例为剖宫产术后腹壁切口子宫内膜异位症（94.05%）;5例为阴道分娩后会阴切口子宫内膜异位症（5.95%）.发病潜伏期1～132个月,所有患者均行手术治疗,术后病理确诊,83例完整切除病灶,未加用药物治疗,随访6～24个月,3例复发,再次手术后继续随访1年无复发.结论 产后切口部位子宫内膜异位症多发于剖宫产术后的腹壁切口,阴道分娩后的会阴切口病灶少见,会阴病灶切除相对困难,手术完全切除病灶后可不加用药物治疗.

Objective To explore the clinical features and diagnosis of postpartum incision endometriosis. Methods Clinical data of 84 patients with postpartum incision endometriosis were retrospectively analyzed. Results In 84 patients,79 cases（94.05% ） were diagnosed with endometriosis in abdominal incision, the remaining 5 cases （5.95%） had perineal incision endometriosis. The incubation period was 1-132 months. All patients underwent surgery ,and the pathological diagnosis was obtained after operation. The endometrial lesions were completely resected in 83 cases without postoperative drugs. Recurrence was observed in 3 cases during the 6-24 months follow-up. After reoperation, no recurrence occurred with another 1 year follow-up. Conclusion Most of postpartum incision endometriosis are in abdominal incision after caesarean delivery,the lesions in perineum incision are rare after vaginal delivery. The endometrial lesions in perineal incision is relatively difficult to remove. Surgery can completely resect the endometrial lesions without additional drug treatment.