摘要
目的:研究剖宫产术后腹壁子宫内膜异位症(AWE)的临床表现、分型及其对手术治疗的意义。方法:对青岛大学附属医院2010年2月至2017年8月收治的剖宫产术后AWE 174例患者的临床资料进行回顾性的分析总结,根据超声检查结节浸润位置的深浅分型为:皮下脂肪型(F1)、前鞘肌肉型(F2)、皮下脂肪+前鞘肌肉型(F3)、前鞘肌肉+腹膜型(F4)、皮下脂肪+前鞘肌肉+腹膜型(F5)。结果:174例中118例以腹壁切口包块为首发表现,56例经期腹壁切口包块疼痛为首发表现。剖宫产手术横切口左右两侧包块占81.61%,166例为单发,8例多发。所有患者腹壁超声检查,见下腹壁切口处低回声结节。174例中F1型19例,F2型18例,F3型112例,F4型9例,F5型16例,全部采用手术切除病灶。AWE各临床分型组麻醉方式、手术时间、出血量间差异均有统计学意义(P<0.05)。不同直径包块的手术时间、出血量比较差异均有统计学意义(P<0.05)。结论:剖宫产术后AWE以腹壁切口包块为主要表现,单发包块占绝大多数。术前超声检查可提供重要的诊断及分型依据。均行手术切除病灶,手术时间、出血量与包块直径有一定关系,其AWE临床分型对于麻醉方式的选择、手术时间的掌握及术中出血量的估计具有临床意义。
Objective：To study the clinical manifestation and classification of abdominal wall endometriosis after cesarean section and explore their significance to surgical treatment. Methods ：The clinical data of 174 cases of abdominal wall endometriosis after cesarean section from February 2010 to August 2017 in the Affiliated Hospital of Qingdao University were retrospectively analyzed and summarized. Clinical types were classified based on the degree of infiltration of nodules：within the abdominal wall fat（ F1 ）, within the rectus abdominis and its anterior sheath （ F2）, within the abdominal wall fat and the rectus abdominis and its anterior sheath （ F3）, within the rectus abdominis and its anterior sheath and the peritoneum （ F4）, within the abdominal wall fat, the rectus abdominis and its anterior sheath and the peritoneum （ F5 ）. Results： In 118/174 cases, abdominal wall incision nodule was the main manifestation, and other 56 cases with abdominal wall incision nodule, pain was the initial symptom. Abdominal wall incision mass at the left and right sides of the transverse incision accounted for 81.61%. 166 cases with single nodule and 8 cases with multiple nodules. Hypoechoic nodules at the incision of the lower abdominal wall can be seen in all patients of ultrasound examination of abdominal wall. Among the 174 cases F1 had 19 cases, F2 had 18 cases, F3 had 112 cases, F4 had 9 cases and F5 had 16 cases. All patients underwent surgery of remove the lesion. There were significant differences in the ways of anesthesia, operation time and the amount of bleeding in each classified group as well as the length of operative time and intraoperative bleeding in different diameters of mass （ P 〈 0.05 ）. Conclusions： Abdominal wall incision nodule was the main manifestation of abdominal wall endometriosis after cesarean section,and most of them with single nodule. Preoperative ultrasonography provided an important diagnostic foundation. All patients underwent surgery of remove the lesion. Th
作者
霍飞霞
欧慧慧
纪新强
孔阁
HUO Feixia;OU Huihui;JI Xinqiang(Affiliated Hospital of Qiingdao University,Qingdao Shandong 266011,China;Qingdao Municipal Hospital,Qingdao Shandong 266011,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2018年第7期523-526,共4页
Journal of Practical Obstetrics and Gynecology
关键词
腹壁子宫内膜异位症
临床分型
诊断
治疗
Abdominal wall endometriosis
Clinical classification
Diagnosis
Treatment
