腹壁子宫内膜异位症231例临床特点及诊治预后分析  

Clinical features,diagnosis,treatment and prognosis of 231 cases of abdominal wall endometriosis

作　　者：蒋梦雨 李留霞[1] 朱迎[1] JIANG Mengyu;LI Liu-xia;ZHU Ying(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学第一附属医院妇产科,河南郑州450003

出　　处：《中国实用妇科与产科杂志》2020年第4期361-364,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：河南省医学科技攻关计划(201602013)。

摘　　要：目的探讨不同临床分型腹壁子宫内膜异位症(abdominal wall endometriosis,AWE)的临床特点、诊治方法及预后影响因素。方法对2012年1月至2018年6月郑州大学第一附属医院住院手术治疗的231例AWE患者的资料进行回顾分析,包括患者的发病年龄、潜伏期、病灶大小、辅助检查方法、手术范围、术后是否应用促性腺激素释放激素激动剂(GnRH-a)、疗效、术后复发的影响因素等。结果 231例AWE患者中229例既往有剖宫产史,术前彩超与术中探查分型总体符合率达97.38%(223/229)。术后随访时间1~6年,随访病例资料完整的患者216例,其中8例复发,复发时间为术后6个月至2年,总体复发率3.70%(8/216);术后使用GnRH-a组与单纯手术组复发率比较,差异无统计学意义(4.35%vs. 3.53%,P>0.05),复发组平均年龄、平均潜伏期均小于未复发组,差异有统计学意义(P<0.05)。结论腹壁子宫内膜异位症绝大多数有剖宫产史。不同的临床分型有不同的临床症状,手术彻底切除病灶是有效的治疗方法。术后使用GnRH-a不能降低复发率,发病年龄早及潜伏期短的患者术后易复发,应重点加以关注和预防。Objective To investigate the clinical features,diagnosis,treatment and influencing factors of prognosis of the different clinical types of abdominal wall endometriosis(AWE).Methods The data of 231 cases of AWE receiving surgical treatment from January 2012 to June 2018 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed and summarized,including the patients’ age of onset,incubation period,lesion size,auxiliary examination method,surgical range,postoperative GnRH-a application,efficacy,and influencing factors of postoperative recurrence.Results All the patients had the history of cesarean section except two. The overall coincidence rate between preoperative ultrasound and intraoperative exploration classification reached 97.38%(223/229). A total of 216 patients with complete case data were followed up for 1 year to 6 years,and 8 of them had recurrence. The recurrence time was 6 months to 2 years after the operation,and the overall recurrence rate was 3.70%(8/216). Postoperative GnRH-a treatment had no impact on postoperative recurrence(4.35% vs. 3.53%,P>0.05). The mean age and average incubation period in the recurrence group were smaller than those in the non-recurrence group,and the difference was statistically significant(P<0.05).Conclusions The vast majority of AWE has the history of cesarean section. Different clinical types have different clinical symptoms. Surgery is the main treatment method,which is effective in complete resection of lesion. Postoperative use of GnRH-a can not reduce the recurrence rate. Patients with early onset age and short incubation period are prone to postoperative recurrence,which should be focused on and prevented.

关 键 词：腹壁子宫内膜异位症 临床分型 诊治 预后 

分 类 号：R711.71[医药卫生—妇产科学]