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目的探讨腹壁子宫内膜异位症(abdominal wall endometriosis,AWE)患者的疾病特征。方法通过PubMed检索,检索词为:abdominal wall endometriosis,extrapelvic endometriosis,scar endometriosis,incisional endometriosis,inguinal endometriosis,umbilical endometriosis,ectopic endometriosis,cutaneous endometriosis,关系为“or”。限定检索词在title/abstract中,发表期限为1980年至2012年间,依据纳入及排除标准,筛选出文献共31篇,病例数共441例。用STATA10.0统计软件处理。结果研究对象中,剖宫产术后病例278例,占63.04%(278/441);经腹子宫全切术后病例44例,占9.98%(44/441);其他手术或操作后病例33例,占7.48%(33/441);自发性病例63例,占14.29%(63/441)。平均年龄为32.17岁(95%CI 29.59~34.97岁),Q=4.811,df=10,P=0.903,I2=0。平均无症状期(症状出现与前次手术、操作的间隔时间)为3.95年(95%CI 2.43~6.43年),Q=1.687,df=5,P=0.890,I2=0。平均病灶最大直径为3.30cm(95%CI2.58~4.22cm),Q=7.791,df=5,P=0.168,I2=35.82%。主要就诊症状:包块占(93.22±2.11)%(95%CI88.88%~97.56%),Q=15.446,df=26,P=0.949,I2=0;疼痛占(85.73±2.74)%(95%CI 80.07%~91.39%),Q=19.119,df=25,P=0.791,I2=0;症状具有月经周期相关性者占(58.59±5.55)%(95%CI 47.19%~70.00%),Q=68.584,df=26,P=0.000,I2=62.09%。结论 AWE最常继发于剖宫产手术后,也可发生与经腹全子宫切除术后、羊膜腔穿刺术后、阑尾切除术后,甚至在没有任何腹部手术、操作史的患者也可发病。前次手术、操作后出现症状有时间间隔。主要症状为腹壁痛性包块,93%的患者有腹壁包块,86%的患者主诉疼痛,只有约1%的患者无上述症状,近40%的患者症状与月经周期不相关,月经周期相关性症状不能作为鉴别诊断的依据。
Objective To investigate the disease characteristics of patients with abdominal wall endometriosis (AWE). Methods The search was performed by PubMed. The search terms were: abdominal wall endometriosis, extrapelvic endometriosis, scar endometriosis, incisional endometriosis, inguinal endometriosis, umbilical endometriosis, ectopic endometriosis, cutaneous endometriosis, relationship “ or”. Qualified terms in title / abstract, published in the period of 1980 to 2012, according to the inclusion and exclusion criteria, screened a total of 31 articles, a total of 441 cases. With STATA10.0 statistical software processing. Results After the cesarean section, 278 cases were accounted for 63.04% (278/441), 44 cases (9.98%) after abdominal hysterectomy, and 44 cases (44/441) after other operation or operation cases Cases, accounting for 7.48% (33/441); spontaneous cases in 63 cases, accounting for 14.29% (63/441). The mean age was 32.17 years (95% CI 29.59 to 34.97 years), Q = 4.811, df = 10, P = 0.903, I2 = 0. The mean asymptomatic period (95% CI 2.43 ~ 6.33 years) with Q = 1.687, df = 5, P = 0.890, and I2 = 0 was 3.95 years (interval between symptoms and previous operation and operation). The mean lesion diameter was 3.30 cm (95% CI, 2.48-4.22 cm) with Q = 7.791, df = 5, P = 0.168 and I2 = 35.82%. The main symptoms were: mass (93.22 ± 2.11)% (95% CI88.88% -97.56%), Q = 15.446, df = 26, P = 0.949, I2 = 0 and pain accounted for (85.73 ± 2.74)% 95% CI 80.07% ~ 91.39%), Q = 19.119, df = 25, P = 0.791, I2 = 0; Symptoms accounted for 58.59 ± 5.55% (95% CI 47.19% -70.00% , Q = 68.584, df = 26, P = 0.000, I2 = 62.09%. Conclusions The most common secondary to AWE after cesarean section surgery may also occur with patients who have undergone abdominal hysterectomy, amniocentesis, appendectomy, or even without any abdominal surgery and operating history . The last surgery, there are time intervals after the operation symptoms. The main symptoms were abdominal pain mass, 93% of the patients had abdominal mass, 86% of the patients complained of pain, and only about 1% of the patients had no such symptoms. Nearly 40% of the patients had no correlation with menstrual cycle and menstrual cycle Symptoms can not be used as a basis for differential diagnosis.