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目的:探讨腹壁子宫内膜异位症的临床特点、治疗及预后。方法:回顾性分析87例腹壁子宫内膜异位症患者的临床资料和随访信息。结果:患者平均就诊年龄(30.10±5.30)岁。所有患者有手术史,其中85例有剖宫产病史。主要临床表现为包块周期性疼痛84例,占96.55%,所有患者查体时均可发现腹壁包块,单个病灶多见,病灶累及皮下脂肪层32例(36.78%),累及肌层42例(48.28%),累及筋膜层51例(58.62%),累及腹膜19例(21.84%)。所有病灶均行包块切除术,术后23例患者追加药物治疗,多数患者选择促性腺激素释放激素激动剂。术后随访期间5例患者复发,复发率5.75%。结论:腹壁切口内异症具有典型的临床表现,结合病史和B超检查容易发现;手术是治疗AWE的首选方法,范围应达病灶外1 cm以上;病灶复发可多次手术治疗,但应警惕恶变可能。
Objective: To investigate the clinical features, treatment and prognosis of abdominal wall endometriosis. Methods: The clinical data and follow-up information of 87 patients with abdominal wall endometriosis were retrospectively analyzed. Results: The average age of patients (30.10 ± 5.30) years of age. All patients had a history of surgery, of which 85 had a history of cesarean delivery. The main clinical manifestations of pelvic pain were 84 cases, accounting for 96.55%, all patients can be found when the abdominal mass examination, single lesions more common in lesions involving the subcutaneous fat layer in 32 cases (36.78%), involving the myometrium in 42 cases (48.28%), involving 51 cases of fascia (58.62%) and 19 cases of peritoneum (21.84%). All lesions underwent mass excision. After the operation, 23 patients were additionally treated with drugs. Most patients chose gonadotropin-releasing hormone agonist. During the follow-up period, 5 patients relapsed and the recurrence rate was 5.75%. Conclusion: Abdominal wall incision endometriosis has a typical clinical manifestations, combined with history and B-ultrasound easy to find; surgery is the preferred method of treatment of AWE, the scope should be up to 1 cm above the lesion; recurrence may be repeated surgery, but should be vigilant Malignant change possible.