关键词: 腹壁, 子宫内膜异位症, 剖宫产术, 治疗, 综合预防

Abstract: Objective：To explore the clinical characteristics， treatment as well as prevention of abdominal wall endometriosis（AWE）. Methods：65 cases of AWE treated at Tianjin Central Hospital of Obstetrics and Gynecology from year 2008 to 2009 were reviewed. The average age was（30.7±3.6）years，range from 23 to 37 years. All of whom undergone the first cesarean section presented with pain and mass of cesarean scar 8 to 36 months after surgery，were hospitalized 9 to 72 months after surgery. The size of mass was from 1 cm × 2 cm to 4 cm × 4.5 cm. The characteristics of mass include unclear edge，solid，hard，tenderness and inmovable. In 23 cases，CA125 were mildly elevated. Results：All the cases were secondry to cesarean section. Of 65 cases with AWE，49 were located in adipose layer，13 cases were as deep as rectus abdominis. Peritoneal were invaded in 3 cases. All cases were received surgical treatment while in 5 cases which lesion diameter > 4 cm were given gonadotropin releasing hormone agonist（GnRHa） treatment for 3 times（per 28-32 day）prior to surgery. No recurrence was observed during 4-20 month follow-up and postoperative administration for 3 months. Conclusions：AWE could be diagnosed according to its medical history，typical clinical manifestations as well as gynecological check-up. Surgical treatment is the preferred choice. A complete excision with clear margin is very important. Medicine treatment after operation can prevent recurrence. Appropriately preventive measure is important during cesarean section.

Key words: Abdominal wall, Endometriosis, Cesarean section, Therapy, Universal precautions