摘要
目的分析129例剖宫产术后腹壁子宫内膜异位症(abdominal wall endometriosis,AWE)患者的临床资料,提出预防措施。方法回顾性分析2010年4月至2021年4月在中国人民解放军东部战区总医院接受手术的129例剖宫产术后AWE患者的临床特征、辅助检查情况、治疗结果及预后。根据病灶侵及组织的最深部位将AWE分为脂肪前鞘型、腹直肌型、腹膜型。根据是否合并盆腔子宫内膜异位症(endometriosis,EMT)将AWE分为AWE不合并盆腔EMT组及AWE合并盆腔EMT组。比较不同分组间差异。结果脂肪前鞘型、腹直肌型、腹膜型AWE患者的病程、病灶直径和术后住院时间比较差异有统计学意义(P<0.05)。腹直肌型和腹膜型病程、病灶直径及术后住院时间显著大于脂肪前鞘型(P<0.05)。AWE患者病程越长、病灶越大、血清CA125水平越高,术后住院时间越长(P<0.05)。腹直肌型和腹膜型血清CA125水平显著高于脂肪前鞘型(P<0.05)。腹膜型中性粒细胞与淋巴细胞比率(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比率(platelet to lyrmphocyte raion,PLR)显著高于脂肪前鞘型(P<0.05)。AWE合并盆腔EMT组患者的纤维蛋白原、NLR、PLR、血清CA125水平显著高于AWE不合并盆腔EMT组(P<0.05),PT显著短于AWE不合并盆腔EMT组(P<0.05)。随访129例患者,未用药组和用药组复发率比较差异无统计学意义(P>0.05)。结论临床上预防AWE的发生是关键,早发现早治疗,患者NLR、PLR和血清CA125水平的高低可提示AWE病灶深度和是否合并盆腔异位病灶。
Objective To analysis the clinical data of 129 patients with abdominal wall endometriosis(AWE)after cesarean section and to propose preventive measures.Methods The clinical features,auxiliary examinations,treatment and prognosis of 129 patients with AWE after cesarean section,who underwent surgery in General Hospital of Eastern Theater Command of People's Liberation Army from April 2010 to April 2021 were analyzed.According to the deepest part of the lesions invading the tissues,AWE was divided into fat and anterior rectus sheath type,rectus abdominis type and peritoneum type.According to with or not with pelvic endometriosis(EMT),AWE was divided into two groups:AWE without pelvic EMT group and AWE with pelvic EMT group.Compared differences between different groups.Results There were significant differences in the course of disease,the size of lesion and the postoperative hospital stay among patients with AWE of fat and anterior rectus sheath type,rectus abdominis type,and peritoneum type(P<0.05).The course of disease,the size of lesion and the postoperative hospital stay of rectus abdominis type and peritoneal type were significantly bigger than that of fat and anterior rectus sheath type(P<0.05).The longer the course of disease,the larger the lesion,the higher the serum CA125 level and the longer the postoperative hospital stay in the patients with AWE(P<0.05).The level of serum CA125 of rectus abdominis type and peritoneum type were significantly higher than that of fat and anterior rectus sheath type(P<0.05).NLR and PLR in peritoneum type were significantly higher than those in fat and anterior rectus sheath type(P<0.05).FIB,NLR,PLR and the level of serum CA125 in patients with pelvic EMT was significantly higher than those in patients without pelvic EMT,and PT shorter than that of patients without pelvic EMT(P<0.05).During the follow-up of 129 patients,there was no significant difference in the recurrence rate between the non-medication group and the medication group(P>0.05).Conclusion The prevention of AWE is the key.The levels of NLR,PLR and serum CA125 can be used to indicate the depth of AWE lesions and the presence of pelvic ectopiclesions.
作者
钱敏
税迎春
胡蝶
刘星妍
王文琪
杨林东
Qian Min;Shui Yingchun;Hu Die;Liu Xingyan;Wang Wenqi;Yang Lindong(Department of Obstetrics and Gynecology,General Hospital of Eastern Theater Command of People's Liberation Army,Nanjing Jiangsu 210002,P.R.China)
出处
《中国计划生育和妇产科》
2023年第5期95-99,共5页
Chinese Journal of Family Planning & Gynecotokology
基金
中国人民解放军东部战区总医院院内青年课题(项目编号:YYQN2021100)。
作者简介
钱敏,毕业于华中科技大学,硕士研究生,主治医师,主要研究方向为妇科肿瘤;通信作者:杨林东,E-mail:yanglingdong-123@163.com。
