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、治疗和预防。方法对30例腹壁切口子宫内膜异位症患者的临床资料进行回顾性分析。结果30例患者均继发于剖宫产术后6个月至2年，主要表现为腹壁切口瘢痕及周围组织不同程度的疼痛性结节或肿块且与月经周期有关；所有患者均行局部病灶切除术后以米非司酮治疗3至6个月，随访1年无复发。结论剖宫产术是子宫内膜异位症的重要医源性因素，预防的关键是减少剖宫产率和术中的切口保护，手术切除是唯一有效的治疗方法，术后药物辅助治疗有利于预防复发。
목적：탐토부궁산술후복벽절구자궁내막이위증적림상진단、치료화예방。방법대30례복벽절구자궁내막이위증환자적림상자료진행회고성분석。결과30례환자균계발우부궁산술후6개월지2년，주요표현위복벽절구반흔급주위조직불동정도적동통성결절혹종괴차여월경주기유관；소유환자균행국부병조절제술후이미비사동치료3지6개월，수방1년무복발。결론부궁산술시자궁내막이위증적중요의원성인소，예방적관건시감소부궁산솔화술중적절구보호，수술절제시유일유효적치료방법，술후약물보조치료유리우예방복발。
Objective To investigate the clinical diagnosis,treatment and prevention of inci-sional abdominal wall endometriosis after cesarean section.Methods Clinical data of 30 patients with incisional abdominal wall endometriosis after cesarean section were analyzed retrospectively. Results The incisional abdominal wall endometriosis occurred 6-24 months after cesarean section in all the 30 patients.The main clinical features included incision scar and painful nodules or mas-ses in surrounding tissues,and the characteristics were associated with menstrual cycle.All pa-tients were treated with mifepristone for 3-6 months after local lesion resection.No recurrence oc-curred during the 1-year follow-up.Conclusion Cesarean section is the important iatrogenic fac-tor for endometriosis.The decreased cesarean section rate and intraoperative incision protection are keys to the prevention of incisional endometriosis after cesarean section,and surgical resection is the only effective method for the treatment of incisional endometriosis after cesarean section. Postoperative drug adj uvant therapy can prevent the recurrence of incisional endometriosis.