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目的:探讨腹壁子宫内膜异位症的发病特点及手术治疗效果,以提高诊治水平。方法:分析27例经手术病理证实为腹壁子宫内膜异位症患者的临床资料,包括发病年龄、既往手术病史、临床症状与月经的关系、发病时间、病灶数量及手术效果。结果:27例患者发病年龄为24~43岁,平均32.22岁,中位年龄32岁,以30~39岁年龄段发病人数最多(18/27,66.67%),与其他年龄段比较差异有统计学意义(P<0.01)。27例既往均有剖宫产史,且均以切口区疼痛性包块就诊,其中切口区单发病灶者24例(88.89%),2处病灶3例(11.11%)。临床症状及包块大小变化与月经的关系密切者21例(77.78%),关系不明显6例(22.22%),两者差异有统计学意义(χ2=16.67,P<0.01)。腹壁子宫内膜异位症发病时间为术后3个月~7年不等,以术后2年发病率最高(55.56%)。结论:腹壁子宫内膜异位症具有典型的临床表现,术前诊断不难,手术切除近期疗效满意,彻底切除病灶、适度切除周围正常组织是预防其复发的关键。
Objective: To investigate the incidence of abdominal wall endometriosis and surgical treatment effect, in order to improve the diagnosis and treatment level. Methods: The clinical data of 27 patients with endometriosis confirmed by surgery and pathology were analyzed, including the age of onset, the history of previous surgery, the relationship between clinical symptoms and menstruation, the time of onset, the number of lesions and the surgical effect. Results: The onset age of 27 patients was 24-43 years (average 32.22 years), with a median age of 32 years and the highest incidence was in the age group of 30-39 years (18 / 27,66.67%), with statistical difference compared with other age groups Significance (P <0.01). Twenty-seven cases had history of cesarean section, and all were treated with painful mass in the incision area, including 24 cases (88.89%) with single lesion in the incision area and 3 cases (11.11%) with 2 lesions. There were 21 cases (77.78%) of the clinical symptoms and masses with close relationship with menstruation, 6 cases (22.22%) with no obvious relationship (χ2 = 16.67, P <0.01). The onset of abdominal wall endometriosis ranged from 3 months to 7 years after operation, with the highest incidence (55.56%) 2 years after operation. Conclusions: Abdominal wall endometriosis has the typical clinical manifestations. It is not difficult to diagnose the disease before the operation. Surgical resection has satisfactory curative effect in the near future. Thorough resection of the lesion and proper removal of surrounding normal tissues are the key points to prevent recurrence.