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目的探讨腹壁及会阴部子宫内膜异位症的诊断、治疗及预防。方法对19例腹壁及会阴部子宫内膜异位症患者的临床资料进行回顾性分析。结果所有病例均行异位病灶切除术,术后均确诊为子宫内膜异位症。16例病灶位于腹壁者中,术后明确6例位于皮下,8例侵入腹直肌筋膜前鞘,2例侵入腹膜;3例位于会阴部者中,2例位于皮下,1例多发病灶累及肛提肌。术后随诊6个月至5年未见复发。结论腹壁及会阴部子宫内膜异位症的临床特点为与月经周期同步、周期性疼痛、伴进行性增大肿块。诊断以症状、体征为主,B超可协助诊断。治疗的有效手段为手术切除异位病灶。预防的关键是尽量避免子宫内膜组织遗留在手术切口上。
Objective To investigate the diagnosis, treatment and prevention of abdominal wall and perineal endometriosis. Methods The clinical data of 19 patients with abdominal wall and perineal endometriosis were analyzed retrospectively. Results All patients underwent ectopic resection and were diagnosed as endometriosis after operation. Sixteen cases were located in the abdomen. Six cases were located subcutaneously, eight cases invaded the anterior fascia of the rectus abdominis and two cases invaded the peritoneum. Three cases were located in the perineal region, two were subcutaneously and one case had multiple lesions Levator ani muscle. Follow-up 6 months to 5 years after operation no recurrence. Conclusions The clinical features of abdominal wall and perineal endometriosis are synchronous with menstrual cycle, periodic pain, with progressive mass enlargement. Diagnosis of symptoms, signs, B-can help diagnose. Effective treatment for the surgical removal of ectopic lesions. The key is to prevent the endometrial tissue left in the surgical incision.