腹壁子宫内膜异位症的治疗进展

doi:10.12280/gjfckx.20241057

摘要/Abstract

摘要：

腹壁子宫内膜异位症（abdominal wall endometriosis，AWE）是一种罕见的盆腔外子宫内膜异位症，通常与既往腹部手术史有关，尤其是剖宫产手术。其主要症状为周期性腹痛和腹壁肿块。AWE的诊断主要依赖超声检查，但最终确诊需通过活组织检查。治疗AWE的方法多种多样，药物治疗，如口服避孕药、孕激素和促性腺激素释放激素激动剂，可暂时缓解症状，但停药后易复发。手术切除病灶是目前的主要治疗手段，但存在术后腹壁缺损、切口感染和愈合延迟等风险。近年来，微波消融、高强度聚焦超声、射频消融和经皮冷冻消融等微创技术在AWE治疗中得到应用，具有创伤小、恢复快等优势。此外，针灸等传统中医疗法也被证明可在一定程度上缓解相关症状。对于复杂性AWE，多学科团队协作在治疗中发挥重要作用，通过联合普通外科、妇产科和整形外科等多学科，实现个体化和精准化治疗。未来，随着更多临床研究的开展，有望进一步优化AWE的治疗策略，降低复发率，提高患者生活质量。

关键词: 子宫内膜异位症, 腹壁, 治疗, 妇科外科手术, 微创, 多学科团队协作

Abstract:

Abdominal wall endometriosis (AWE) is a rare form of extra-pelvic endometriosis usually associated with a history of previous abdominal surgery, especially cesarean section. Its main symptoms are periodic abdominal pain and an abdominal wall mass. The diagnosis of AWE relies mainly on ultrasonography, but final confirmation of the diagnosis is by biopsy. There are various treatment options for AWE. Medication, such as oral contraceptives, progesterone and gonadotropin-releasing hormone agonists, can provide temporary relief of the symptoms but are prone to recurrence after discontinuation of the medication. Surgical excision of the lesions is the main treatment at present, but there are risks of postoperative abdominal wall defects, incision infection and delayed healing. In recent years, minimally invasive techniques such as microwave ablation, high-intensity focused ultrasound, radiofrequency ablation, and percutaneous cryoablation have been applied in AWE treatment, which have the advantages of less trauma and faster recovery. In addition, traditional Chinese medical treatments such as acupuncture have also been shown to alleviate the associated symptoms to a certain extent. For complex AWE, multidisciplinary teamwork plays an important role in treatment, and individualized and precise treatment is achieved by combining multiple disciplines such as general surgery, obstetrics and gynecology, and plastic surgery. In the future, with more clinical studies, it is anticipated to further optimize the treatment strategy of AWE, reduce the recurrence rate and improve the quality of life of patients.

Key words: Endometriosis, Abdominal wall, Therapy, Gynecologic surgical procedures, Minimally invasive, Multidisciplinary team collaboration

江爱美, 张信美. 腹壁子宫内膜异位症的治疗进展[J]. 国际妇产科学杂志, 2025, 52(2): 211-216.

JIANG Ai-mei, ZHANG Xin-mei. Advances in the Treatment of Abdominal Wall Endometriosis[J]. Journal of International Obstetrics and Gynecology, 2025, 52(2): 211-216.

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