[1]张 平,孙亚兵,张 晨,等.剖宫产疤痕子宫内膜异位症临床研究[J].南京师范大学学报(自然科学版),2018,41(01):97.[doi:10.3969/j.issn.1001-4616.2018.01.017]
　Zhang Ping,Sun Yabing,Zhang Chen,et al.A Clinical Study of Cesarean Scar Endometriosis[J].Journal of Nanjing Normal University(Natural Science Edition),2018,41(01):97.[doi:10.3969/j.issn.1001-4616.2018.01.017]
点击复制

剖宫产疤痕子宫内膜异位症临床研究()
分享到：

《南京师范大学学报》（自然科学版）[ISSN:1001-4616/CN:32-1239/N]

卷:
第41卷
期数:
2018年01期
页码:
97
栏目:
·生命科学·
出版日期:
2018-03-31

文章信息/Info

Title:
A Clinical Study of Cesarean Scar Endometriosis
文章编号:
1001-4616(2018)01-0097-05
作者:
张 平; 孙亚兵; 张 晨; 杨叶平; 张琳娜; 许 泓
上海交通大学医学院附属国际和平妇幼保健院,上海 200030
Author(s):
Zhang Ping; Sun Yabing; Zhang Chen; Yang Yeping; Zhang Linna; Xu Hong
The International Peace Maternity and Child Health Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200030,China
关键词:
腹壁子宫内膜异位症; 剖宫产术; 剖宫产疤痕子宫内膜异位症; Pfannenstiel切口
Keywords:
abdominal wall endometriosis; cesarean section; cesarean scar endometriosis; Pfannenstiel incision
分类号:
R713.1
DOI:
10.3969/j.issn.1001-4616.2018.01.017
文献标志码:
A
摘要:
剖宫产疤痕子宫内膜异位症是一种少见的医源性疾病,本研究旨在探讨其临床特征和预防方法. 回顾分析本院2007年1月至2016年12月剖宫产疤痕子宫内膜异位症患者的临床资料,共有169例剖宫产疤痕子宫内膜异位症患者被纳入研究. 患者平均年龄(32.0±3.9)岁,产次1～2次. 潜伏期平均为(31.4±23.7)月,与患者年龄、产次等基本特征无明显相关性. 80.5%的患者既往剖宫产为Pfannenstiel切口,19.5%的患者为正中纵形切口. 统计学分析发现,Pfannenstiel切
Abstract:
Abdominal wall endometriosis after cesarean section,also named cesarean scar endometriosis(CSE),is an uncommon iatrogenic disease. The aim of this study is to identify the clinical features of CSE and recommend precautionary measures. A retrospective study was undertaken for CSE patients treated surgically at a university hospital in China between January 2007 and December 2016. The final sample included 169 CSE cases. The mean age of the patients was(32.0±3.9)years,and parity ranged from 1 to 2. The latent period of the CSE was(31.4±23.7)months. No significant latent period difference was identified based on patients’ baseline characteristics. A majority(80.5%,n=136)of the patients had Pfannenstiel incisions,and a minority(19.5%,n=33)had vertical midline incisions. The latent period of the CSE in Pfannenstiel incision was significantly shorter than that in vertical midline incision(24.0 vs 36.0,P=0.005),and the latent period in patients with multiple endometriomas was significantly shorter than that in patients with a single endometrioma(12.0 vs 24.0,P=0.034). Lesions of scar endometrioma were more common in both corner sites:121/145(83.4%)in Pfannenstiel incision scars and 28/33(84.8%)in vertical midline incision scars. Although further studies are needed,the findings of this study suggest that Pfannenstiel incision carries a higher risk of CSE than vertical midline incision. Thorough cleaning at the conclusion of CS,particularly both corner sites of the adipose layer and fascia layer,are strongly recommended for CSE prevention.

参考文献/References:

[1] WILLIAMS H E,BARSKY S,STORINO W. Umbilical endometrioma(silent type)[J]. Arch Dermatol,1976,112(10):1 435-1 436.
[2]IDEYI S C,SCHEIN M,NIAZI M,et al. Spontaneous endometriosis of the abdominal wall[J]. Dig Surg,2003,20(3):246-248.
[3]BLANCO R G,PARITHIVEL V S,SHAH A K,et al. Abdominal wall endometriomas[J]. Am J Surg,2003,185(6):596-598.
[4]HORTON J D,DEZEE K J,AHNFELDT E P,et al. Abdominal wall endometriosis:a surgeon’s perspective and review of 445 cases[J]. Am J Surg,2008,196(2):207-212.
[5]NOMINATO N S,PRATES L F,LAUAR I,et al. Caesarean section greatly increases risk of scar endometriosis[J]. Eur J Obstet Gynecol Reprod Biol,2010,152(1):83-85.
[6]CHANG Y,TSAI E M,LONG C Y,et al. Abdominal wall endometriomas[J]. J Reprod Med,2009,54(3):155-159.
[7]MATTER M,SCHNEIDER N,MCKEE T. Cystadenocarcinoma of the abdominal wall following caesarean section:case report and review of the literature[J]. Gynecol Oncol,2003,91(2):438-443.
[8]LENG J,LANG J,GUO L,et al. Carcinosarcoma arising from atypical endometriosis in a cesarean section scar[J]. Int J Gynecol Cancer,2006,16(1):432-435.
[9]GAUNT A,HEARD G,MCKAIN E S,et al. Caesarean scar endometrioma[J]. Lancet,2004,364(9 431):368.
[10]DEMIR B,SENERBAHCE Z,GUZEL A I,et al. Abdominal wall endometriosis following cesarean section:report of five cases[J]. Clin Exp Obstet Gynecol,2011,38(3):288-290.
[11]BEKTAS H,BILSEL Y,SARI Y S,et al. Abdominal wall endometrioma; a 10-year experience and brief review of the literature[J]. J Surg Res,2010,164(1):e77-81.
[12]ZHAO X,LANG J,LENG J,et al. Abdominal wall endometriomas[J]. Int J Gynaecol Obstet,2005,90(3):218-222.
[13]MATHAI M,HOFMEYR G J. Abdominal surgical incisions for caesarean section[J]. Cochrane Database Syst Rev,2007,24(1):CD004453.
[14]KISIELINSKI K,CONZE J,MURKEN A H,et al. The Pfannenstiel or so called“bikini cut”:still effective more than 100 years after first description[J]. Hernia,2004,8(3):177-181.
[15]HAERI A D. Comparison of transverse and vertical skin incisions for Caesarean section[J]. S Afr Med J,1976,50(2):33-34.
[16]WANG P H,JUANG C M,CHAO H T,et al. Wound endometriosis:risk factor evaluation and treatment[J]. J Chin Med Assoc,2003,66(2):113-119.
[17]KANG J,BAEK J H,LEE W S,et al. Clinical manifestations of abdominal wall endometriosis:a single center experience[J]. Arch Gynecol Obstet,2013,287(2):301-305.
[18]MCLAREN J. Vascular endothelial growth factor and endometriotic angiogenesis[J]. Hum Reprod Update,2000,6(1):45-55.
[19]TENG C C,YANG H M,CHEN K F,et al. Abdominal wall endometriosis:an overlooked but possibly preventable complication[J]. Taiwan J Obstet Gynecol,2008,47(1):42-78.

备注/Memo

备注/Memo:
收稿日期:2017-06-19.
基金项目:上海市自然科学基金(15ZR1444100、17411972800).
通讯联系人:许泓,主任医师,硕士生导师,研究方向:子宫内膜异位症. E-mail:xuhong1168@126.com
更新日期/Last Update: 2018-03-31