CAJ | 학술논문

目的：探讨剖宫产术后腹壁切口子宫内膜异位症的临床诊断及治疗情况。方法选取2005年10月～2012年8月经手术治疗腹部切口子宫内膜异位的患者30例，对30例患者的临床资料进行回顾性分析。结果30例腹部切口子宫内膜异位症患者4例病灶累及腹膜，5例累及肌层，14例累及腹肌前鞘。行异位病灶切除手术，手术效果良好，无复发。手术患者病灶均为一次手术切除，30例手术的患者完全治愈,治愈率100%。病理检查增生的结缔组织中可以见到子宫内膜腺体结构及间质细胞。符合子宫内膜异位症的诊断。术后23例患者随访1～3年，无复发病例。结论剖宫产手术是腹壁切口子宫内膜异位症最重要的医源性因素,应严格依照剖宫产手术适应证可降低剖宫产率，手术是唯一有效的治疗方法；规范手术操作是预防本病发生的关键。
목적：탐토부궁산술후복벽절구자궁내막이위증적림상진단급치료정황。방법선취2005년10월～2012년8월경수술치료복부절구자궁내막이위적환자30례，대30례환자적림상자료진행회고성분석。결과30례복부절구자궁내막이위증환자4례병조루급복막，5례루급기층，14례루급복기전초。행이위병조절제수술，수술효과량호，무복발。수술환자병조균위일차수술절제，30례수술적환자완전치유,치유솔100%。병리검사증생적결체조직중가이견도자궁내막선체결구급간질세포。부합자궁내막이위증적진단。술후23례환자수방1～3년，무복발병례。결론부궁산수술시복벽절구자궁내막이위증최중요적의원성인소,응엄격의조부궁산수술괄응증가강저부궁산솔，수술시유일유효적치료방법；규범수술조작시예방본병발생적관건。
Objective To explore the clinical diagnosis and treatment of abdominal incisional endometriosis after cesarean section.Methods 30 patients who received surgery of abdominal incisional endometriosis from October 2005 to August 2012 were selected.Clinical data of the 30 patients were retrospectively analyzed.Results 4 of 30 patients with abdominal incisional endometriosis had foci involving peritoneum,5 involving muscular layer,and 14 involving protheca of abdominal muscle.Incision of ectopic foci was carried out and the surgical effect was good without any relapse.All patients received the incision of foci only once.All the 30 patients completely recovered with the recovery rate of 100%.Hyperplastic connective tissues via pathological examination showed endometrial glandular structure and interstitial cells.The results accorded with the diagnosis of endometriosis.23 patients received follow-ups after the surgery for 1-3 years,and no relapses were detected.ConclusionCesarean section is the main iatrogenic factor causing abdominal incisional endometriosis.Treatment strictly following surgical indications of Cesarean section helps reduce the rate of Cesarean section, and surgery is the only effective treatment for endometriosis;standardized surgical procedures are the key to prevent the disease.