腹壁子宫内膜异位症的临床特点与分析  

Clinical Characteristics and Analysis of Abdominal Wall Endometriosis

作　　者：郭桑[1] 张锦娜 谢熙[1] GUO Sang;ZHANG Jinna;XIE Xi(Department of Gynecology and Obstetrics,Fujian Maternity and Child Health Hospital,Fuzhou Fujian 350000,China)

机构地区：[1]福建省妇幼保健院妇产科,福建福州350000

出　　处：《中国卫生标准管理》2022年第14期54-57,共4页China Health Standard Management

摘　　要：目的探讨分析腹壁子宫内膜异位症(abdominal wall endometriosis,AWE)的临床特点及其诊治方法。方法对2015年1月—2019年12月福建省妇幼保健院接受手术治疗的89例AWE患者进行了回顾性研究。分析患者的年龄、发病情况、临床特点以及手术情况等特点。按发病部位分为皮下型及肌肉型,进行两组间的临床特点的比较。结果89例患者症状均为自觉经期腹部包块疼痛。患者平均(31.79±5.57)岁,发病潜伏期中位数17.00(12.00,36.00)月,病程中位数28.00(14.50,48.00)月,手术距离末次剖宫产时间中位数57.00(36.00,76.00)月。所有患者既往均有剖宫产术史。术前糖类抗原125(carbohydrate antigen125,CA125)中位数24.40(18.40,42.75)U/mL,术前彩超均提示可见低回声信号影。对比皮下型和肌肉型两组的患者年龄、潜伏期、病程、手术距离末产时间以及彩超血流特点差异无统计学意义。而皮下型AWE的病灶直径较肌肉型AWE小(P=0.001),肌肉型AWE的CA125水平较皮下型AWE高(P=0.008),肌肉型AWE的补片使用率明显较皮下型AWE高(P=0.007),且差异均有统计学意义。结论文章系统地回顾了AWE的临床特征。不同的临床分型具有不同的临床特点,需注意术前诊断及术中探查。目前,手术治疗仍是AWE的最佳治疗方案。Objective To analyze the clinical features,diagnosis and treatment of abdominal wall endometriosis(AWE).Methods A retrospective study was conducted on 89 patients with AWE who underwent surgery in Fujian Maternal and Child Health Hospital from January 2015 to December 2019.According to the location of the disease,it was divided into subcutaneous type and muscular type,and the clinical characteristics between the two groups were compared.Results All 89 patients showed abdominal mass pain during menstruation.The mean age of the patients was(31.79±5.57)years.The median incubation period of onset was 17.00(12.00,36.00)months,the median course of disease was 28.00(14.50,48.00)months,and the median time from surgery to the last cesarean section was 57.00(36.00,76.00)months.All patients had a previous history of cesarean section.The median value of CA125 before surgery was 24.40(18.40,42.75)U/mL,and preoperative color ultrasonography indicated low echo signal shadow.There were no statistically significant differences in age,latency,course of disease,and characteristics of color Doppler ultrasonography between subcutaneous AWE and muscular AWE.The lesion diameter of subcutaneous AWE was smaller than that of muscle AWE(P=0.001),and the carbohydrate antigen 125(CA125)level of muscle AWE was higher than that of subcutaneous AWE(P=0.008).The patch utilization rate of muscle AWE was significantly higher than that of subcutaneous AWE(P=0.007),and the differences were statistically significant.Conclusion The paper systematically reviewed the clinical features of AWE.Moreover,different clinical subtypes have different clinical characteristics,so attention should be paid to preoperative diagnosis and intraoperative exploration.At present,surgical treatment is still the best treatment for AWE.

关 键 词：腹壁子宫内膜异位症 临床特点 临床分型 诊断 治疗 预防 

分 类 号：R711[医药卫生—妇产科学]