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目的探讨腹壁子宫内膜异位(AWE)手术中腹壁筋膜层缺损的修复方法。方法回顾性分析55例腹壁子宫内膜异位症患者的病例资料。将55例患者分为两组:(1)腹壁筋膜层缺损组,29例,术中腹壁筋膜缺损面积超过2 cm2;腹壁筋膜缺损组根据腹壁筋膜层缺损面积(由小到大)处理如下:11例患者常规缝合腹壁;7例患者应用张力线、PDS-Ⅱ或筋膜／皮肤减张缝合重建腹壁; 4例手术中应用筋膜补片;7例腹壁筋膜层和皮肤缺损大的患者由整形科协助应用腹壁成形术和筋膜补片。(2)无腹壁筋膜层缺损组,26例,术中腹壁筋膜缺损面积小于2 cm2。无腹壁筋膜层缺损组常规缝合腹壁。结果所有患者切口Ⅰ期愈合。腹壁筋膜缺损组术前B超测量和切除AWE的最大径线、所需手术时间和出血量显著大于无筋膜缺损组,差异有统计学意义。两组各有1例病情复发。结论B超检查有助于术前准确评估病灶情况。腹壁缺损大于2 cm2时可采用筋膜／皮肤减张缝合进行修复,更大者可采用筋膜补片／腹壁成形术进行修复。
Objective To investigate the repair of abdominal fascia defect in abdominal wall endometriosis (AWE). Methods Retrospective analysis of 55 cases of abdominal wall endometriosis patients data. The 55 patients were divided into two groups: (1) abdominal fascia defect group, 29 cases, intraoperative abdominal fascia defect area of more than 2 cm2; abdominal fascia defect group according to the abdominal fascia defect area (from small to large ) Treated as follows: 11 patients with conventional suture of the abdominal wall; 7 patients with tension line, PDS-Ⅱ or fascia / skin suture reconstruction of the abdominal wall; 4 cases of surgical application of fascia patch; 7 cases of abdominal fascia and skin Patients with large defects are assisted by Plastic Surgery in the application of abdominal wallplasty and fascia patch. (2) No abdominal fascia defect group, 26 cases, intraoperative abdominal fascia defect area less than 2 cm2. No abdominal fascia defect group conventional suture abdominal wall. Results All patients underwent primary incision healing. Abdominal fascia defect group preoperative B-ultrasound measurement and removal of AWE maximum diameter, the required operation time and bleeding volume was significantly greater than the non-fascia defect group, the difference was statistically significant. One case in both groups had a relapse. Conclusion B-ultrasound helps to accurately assess the lesion before surgery. Abdominal wall defects greater than 2 cm2 can be used fascia / skin suture suture repair, the greater the use of fascia patch / abdominal wall repair.