腹壁子宫内膜异位症的研究进展

doi:10.12280/gjfckx.20230034

摘要/Abstract

摘要：

腹壁子宫内膜异位症（abdominal wall endometriosis，AWE）是最常见的盆腔外子宫内膜异位症，主要表现为腹壁肿块逐渐增大，伴进行性加重的周期性疼痛。AWE的发病机制尚不明确，其病灶的形成受到激素、剖宫产孕周和体质量指数等多种因素的影响。临床上AWE可根据病史、症状、体征和影像学检查等诊断。近年来，虽然高强度聚焦超声已用于AWE的治疗，但手术切除仍是AWE的首选治疗方法。术前对AWE进行分型有助于治疗方式的选择，目前可以根据AWE病灶底部侵犯的组织深度分为皮下型、鞘膜型和腹膜型。另外，术中导航、腹壁重建等技术也为精准个体化医疗提供了更多的可能性。并且随着腹腔镜微创技术的发展，腹腔镜也被用于AWE的治疗，但其远期安全性及疗效仍有待探究。

关键词: 子宫内膜异位症, 腹壁, 剖宫产术, 妇科外科手术, 腹腔镜手术, 体外冲击波疗法

Abstract:

Abdominal wall endometriosis (AWE) is the most common form of external pelvic endometriosis, which is mainly manifested as gradual enlargement of mass in the abdominal wall, accompanied by progressive and aggravated periodic pain. The pathogenesis of AWE is still unclear, and the formation of the focus is affected by a number of factors, including hormones, gestational weeks of cesarean section, body mass index. Clinically AWE can be diagnosed on the basis of history, symptoms, signs and imaging examination. In recent years, although high-intensity focused ultrasound has been used to treat AWE, but surgical excision is still the preferred treatment. Preoperative classification of AWE helps in the selection of treatment. Currently, according to the depth of tissue invaded by the base of AWE lesion, it can be divided into subcutaneous type, sheath type and peritoneal type. In addition, intraoperative navigation, abdominal wall reconstruction and other technologies also provide more possibilities for accurate personalized medical treatment. With the development of minimally invasive laparoscopic technology, laparoscopy has also been used in the treatment of AWE, but its long-term safety and efficacy remain to be explored.

Key words: Endometriosis, Abdominal wall, Cesarean section, Gynecologic surgical procedures, Laparoscopes, Extracorporeal shockwave therapy

仇凌冰, 李锦波, 陈淑琴. 腹壁子宫内膜异位症的研究进展[J]. 国际妇产科学杂志, 2023, 50(5): 545-549.

QIU Ling-bing, LI Jin-bo, CHEN Shu-qin. Research Progress in Abdominal Endometriosis[J]. Journal of International Obstetrics and Gynecology, 2023, 50(5): 545-549.

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