腹壁子宫内膜异位症的临床分析

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（x2=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。

Clinical analysis on endometriosis of abdominal wall

Objective： To explore clinical characteristics and surgical treatment of abdominal wall endometriosis in order to improve the diagnosis and treatment. Methods. Clinical examination data of 27 patients which were confirmed abdominal wall endometriosis by pathology were analysized, including age, previous surgical history, relationship between clinical symptoms and menstrual, time of onset, number of lesions and surgical results. Results： The onset age of the patients was between 24 to 43 years old, the average onset age was 32.22 years old, the median onset age was 32 years old, the peak incidence of age was 30 to 39 years old （18/27,66.67%）, comparing with other patients＇ ages, the difference were statistically significant （P 〈 0.01 ）. All patients had a history of cesarean section and went to hospital because of painful tumor in the site of incision, there was single lesion in 24 patients （ 88.89% ）, two lesions in 3 cases. A close connection was found between the clinical symptoms, the change in the size of tumor and menstrual cycle in 21 cases （77.78%）. No close connection was found in 6 patients （22.22%）. The difference was significant between the two groups （ P 〈 0.01 ）. Patients suffered from abdominal wall endometriosis 3 to 7 months after the surgery and the incidence was the highest （55.56%） in 2 years after surgery. Conclusions： Abdominal wall endometriosis has typical manifestation. It is not difficult to make a preooerative diaznosis. Satisfactory short-term effect.~ ~onld h~ m~hi~v,~rl hv rnM＋in,, m,r,,i,-Mresection. Complete removal of the lesion and excision moderately surrounding normal tissue is the key to prevent recurrence