腹壁子宫内膜异位症121例临床研究

Clinical study on 121 cases of abdominal wall endometriosis

目的·分析腹壁子宫内膜异位症患者的临床特点和诊治过程,探讨有效的治疗和预防方法。方法·对121例腹壁子宫内膜异位患者的临床资料进行回顾性分析。结果·121例腹壁子宫内膜异位症患者中有120例(99.2%)继发于剖宫产术后,出现临床症状的潜伏期中位数为24个月。在94例(77.7%)描述剖宫产切口类型的患者中,65例(69.1%)为腹壁横切口(Pfannenstiel切口),29例(30.9%)为腹壁正中纵形切口。所有患者均接受内膜异位症病灶切除术,共切除146个病灶,其中上界位于脂肪层的病灶共97个(66.4%),上界位于腹直肌前鞘的病灶共26个(17.8%),上界位于肌层的病灶共23个(15.8%)。结论·积极降低剖宫产率,优化剖宫产手术方式,保护好腹壁切口是预防腹壁子宫内膜异位症发生的关键。

Objective·To analyze clinical characteristics and diagnostic and therapeutic procedure of patients with abdominal wall endometriosis （AWE） and explore effective treatment and prevention methods. Methods·Clinical data of 121 AWE cases were retrospectively analyzed. Results·Of 121 AWE cases, 120 cases （99.2%） were secondary to cesarean section with a median latency of 24 months. Of 94 cases （77.7%） with the description of cesarean section incision type, 65 cases （69.1%） had the transverse incision （Pfannenstiel incision） and the other 29 cases （30.9%） had the vertical midline incision. All patients underwent the excision of endometriosis lesions and a total of 146 lesions were excised. Of 146 lesions, the upper bound of 97 lesions （66.4%） was in the subcutaneous fat layer, the upper bound of 26 lesions （17.8%） was in the anterior rectus sheath, and the upper bound of other 23 cases （15.8%） was in the muscular layer. Conclusion·Decreasing the cesarean section rate, optimizing the cesarean section procedure, and protecting the incision are key factors for the prevention of AWE.