剖宫产术后腹壁子宫内膜异位症手术119例临床分析  

Clinical analysis of 119 cases operation of abdominal wall endometriosis after cesarean section.

作　　者：魏薇[1] 卢丹[1] 张建萍[1] 张亚兰[1] 吕青青[1] 

机构地区：[1]首都医科大学附属北京妇产医院,北京100026

出　　处：《现代妇产科进展》2010年第8期573-575,579,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨剖宫产术后腹壁子宫内膜异位症(AWE)的临床特点、治疗和预防。方法:回顾分析剖宫产术后AWE 119例的临床资料,患者的一般情况,发病症状和时间,手术情况,药物治疗,随访和复发。结果:患者平均年龄32.40±4.25岁,24～39岁占91.6%,94.12%表现为腹壁肿块,86.55%出现疼痛,剖宫产术与出现腹壁肿块平均间隔29.46±24.29月,病灶直径平均3.14±1.14cm,平均1.15±0.465个,横切口单个病灶右侧占46.15%,左侧占34.07%,病灶深部累及部位依次为:腹直肌前筋膜61.34%,腹膜15.97%,肌层12.61%,皮下脂肪层10.08%。106例行单纯病灶切除,合并其他手术13例,手术时间34.54±12.81min,术中出血31.37±25.58ml,切口均一期愈合。合并盆腔子宫内膜异位症5例,占腹腔探查32例的15.63%。5例术前药物治疗,停药后症状复发。119例术后5例复发,复发率4.20%。结论:AWE具有典型的临床表现,手术是唯一有效的治疗方法,AWE好发于切口的两侧角部,采取预防措施可防止发生。Objective：To analyze the clinical characteristics,treatment and prevention of abdominal wall endometriosis（AWE） after cesarean section.Methods：A retrospective study was performed on 119 cases of operation of AWE after cesarean section.The general situation,symptoms,duration of disease,surgical status,medical therapy,follow-up and recurrence were analyzed.Results：The mean age of patients was 32.40±4.25 years.94.12% presented with a mass,86.55% presented with pain.The mean interval from the original surgery to presentation with mass was 29.46±24.29 months.The mean diameter of mass was 3.14±1.14cm and the mean number was 1.15±0.465.For single mass in the pfannenstiel incision scar,46.15% were on the right side and 34.07% were on the left side.The deeply Infiltrating tissues of masses：fascia 61.34%,peritoneum 15.97%,muscle 12.61%,subcutaneous layer 10.08%.106 cases were performed with wide local excision and 13 cases were also performed with other operation.The mean operation time and blood loss were 34.54±12.81min,31.37±25.58ml.5 cases had pelvic endometriosis（15.63% of abdominal exploration）.5 received pre-operative medical management but symptoms recurred after stopping taking medicine.The recurrence rate of 119 cases was 4.20%.Conclusion：AWE has a typical clinical presentation,AWE were common at corner site of the scar after cesarean section.Surgical excision was the only effective treatment,meanwhile,effective preventive strategies for AWE should be recommended.

关 键 词：腹壁 子宫内膜异位症 剖宫产术 

分 类 号：R711.71[医药卫生—妇产科学]