妇产科手术切口子宫内膜异位症的初步治疗效果(1)
[摘要] 目的 探讨妇产科手术切口子宫内膜异位症的治疗效果。方法 选取2013年2月—2015年8月我院收治的妇产科手术切口子宫内膜异位症病人46例，随机分为观察组和对照组。观察组采用一次性病灶清除术及术前/术后药物治疗，对照组采用药物治疗，比较两组病人的临床疗效、康复周期以及住院费用。结果 观察组显效率为82.6%，术后1年随访无病人复发或恶变;对照组显效率为34.8%，术后1年随访4例病人复发。观察组显效率、无效率与对照组比较，差异有统计学意义(χ2=4.792、10.850，P<0.05、0.001)。观察组康复周期为(7.5±1.9)d、治疗费用为(6 954.3±95.2)元，均显著低于对照组的(14.4±1.6)d和(7 187.1±135.7)元，差异有统计学意义(t=6.735、13.320，P<0.001)。结论 对于妇产科手术切口子宫内膜异位症病人，药物与手术联合治疗为最佳治疗手段。
[关键词] 子宫内膜异位症;外科伤口;产科外科手术;药物疗法;治疗结果
[中图分类号] R711.71;R649.9 [文献标志码] A [文章编号] 2096-5532(2020)02-0199-04
doi：10.11712/jms.2096-5532.2020.56.037 [开放科学(资源服务)标识码(OSID)]
[网络出版] http：//kns.cnki.net/kcms/detail/37.1517.R.20200320.1505.001.html;2020-03-23 13：24：51
[ABSTRACT] Objective To investigate the treatment outcome of surgical incision endometriosis in gynecology and obstetrics. Methods A total of 46 patients with surgical incision endometriosis who were treated in our hospital from February 2013 to August 2015 were enrolled and randomly divided into observation group and control group. The patients in the observation group were given one-time debridement and preoperative/postoperative medication， and those in the control group were given medication. The two groups were compared in terms of clinical outcome， period of rehabilitation， and hospital costs. Results The observation group had a marked response rate of 82.6%， and there was no recurrence or malignant transformation during the one-year follow-up after surgery; the control group had a marked response rate of 34.8%， and 4 patients experienced recurrence during the one-year follow-up after surgery. There were significant differences in marked response rate and non-response rate between the observation group and the control group (χ2=4.792，10.850;P<0.05，0.001). Compared with the control group， the observation group had a significantly shorter period of rehabilitation (7.5±1.9 d vs 14.4±1.6 d，t=6.735，P<0.001) and significantly lower treatment costs (6 954.3±95.2 yuan vs 7 187.1±135.7 yuan， t=13.320，P<0.001). Conclusion Surgery combined with medication is an effective treatment method for patients with surgical incision endometriosis in gynecology and obstetrics.
[KEY WORDS] endometriosis; surgical wound; obstetric surgical procedures; drug therapy; treatment outcome
子宮内膜异位症是育龄期妇女的常见病，最常出现异位的部位为卵巢和输卵管，也可出现在子宫肌层、盆腔腹膜、膀胱或结直肠等处[1-2]。国外研究结果也显示，子宫内膜异位症在育龄妇女中发病较多，患病率为10%～15%[3]。目前关于其发病机制提出了几种理论，包括月经逆行、免疫功能改变、体腔上皮化生和转移扩散等[4-5]。然而，子宫内膜异位症确切的发病机制尚不清楚[6-7]。近年来研究结果表明，由于子宫内膜可自行移至妇产科手术切口处形成结节，在腹壁及会阴的手术切口瘢痕处也可发生子宫内膜异位症[8-10]。随着我国剖宫产手术的增加，手术切口子宫内膜异位症的发病率也不断增加。治疗子宫内膜异位症的选择通常是手术，因为药物治疗的效果有限，并且有可能发生恶性肿瘤[11-12]。然而，关于手术治疗卵巢子宫内膜异位症与卵巢储备的关系仍存在争论[13]。由于妇产科手术切口子宫内膜异位症的治疗方法因个体的差异而不尽相同，为了探讨不同方法的治疗效果，提高切口处子宫内膜异位症的治愈率，本研究选取46例妇产科手术切口子宫内膜异位症病人为研究对象，采用药物和手术联合药物两种方法进行治疗，探讨其最佳治疗方法。现将结果报告如下。, 百拇医药(张健 赵敏 王晓孟 王丹 王笑峰 徐琳)
[关键词] 子宫内膜异位症;外科伤口;产科外科手术;药物疗法;治疗结果
[中图分类号] R711.71;R649.9 [文献标志码] A [文章编号] 2096-5532(2020)02-0199-04
doi：10.11712/jms.2096-5532.2020.56.037 [开放科学(资源服务)标识码(OSID)]
[网络出版] http：//kns.cnki.net/kcms/detail/37.1517.R.20200320.1505.001.html;2020-03-23 13：24：51
[ABSTRACT] Objective To investigate the treatment outcome of surgical incision endometriosis in gynecology and obstetrics. Methods A total of 46 patients with surgical incision endometriosis who were treated in our hospital from February 2013 to August 2015 were enrolled and randomly divided into observation group and control group. The patients in the observation group were given one-time debridement and preoperative/postoperative medication， and those in the control group were given medication. The two groups were compared in terms of clinical outcome， period of rehabilitation， and hospital costs. Results The observation group had a marked response rate of 82.6%， and there was no recurrence or malignant transformation during the one-year follow-up after surgery; the control group had a marked response rate of 34.8%， and 4 patients experienced recurrence during the one-year follow-up after surgery. There were significant differences in marked response rate and non-response rate between the observation group and the control group (χ2=4.792，10.850;P<0.05，0.001). Compared with the control group， the observation group had a significantly shorter period of rehabilitation (7.5±1.9 d vs 14.4±1.6 d，t=6.735，P<0.001) and significantly lower treatment costs (6 954.3±95.2 yuan vs 7 187.1±135.7 yuan， t=13.320，P<0.001). Conclusion Surgery combined with medication is an effective treatment method for patients with surgical incision endometriosis in gynecology and obstetrics.
[KEY WORDS] endometriosis; surgical wound; obstetric surgical procedures; drug therapy; treatment outcome
子宮内膜异位症是育龄期妇女的常见病，最常出现异位的部位为卵巢和输卵管，也可出现在子宫肌层、盆腔腹膜、膀胱或结直肠等处[1-2]。国外研究结果也显示，子宫内膜异位症在育龄妇女中发病较多，患病率为10%～15%[3]。目前关于其发病机制提出了几种理论，包括月经逆行、免疫功能改变、体腔上皮化生和转移扩散等[4-5]。然而，子宫内膜异位症确切的发病机制尚不清楚[6-7]。近年来研究结果表明，由于子宫内膜可自行移至妇产科手术切口处形成结节，在腹壁及会阴的手术切口瘢痕处也可发生子宫内膜异位症[8-10]。随着我国剖宫产手术的增加，手术切口子宫内膜异位症的发病率也不断增加。治疗子宫内膜异位症的选择通常是手术，因为药物治疗的效果有限，并且有可能发生恶性肿瘤[11-12]。然而，关于手术治疗卵巢子宫内膜异位症与卵巢储备的关系仍存在争论[13]。由于妇产科手术切口子宫内膜异位症的治疗方法因个体的差异而不尽相同，为了探讨不同方法的治疗效果，提高切口处子宫内膜异位症的治愈率，本研究选取46例妇产科手术切口子宫内膜异位症病人为研究对象，采用药物和手术联合药物两种方法进行治疗，探讨其最佳治疗方法。现将结果报告如下。, 百拇医药(张健 赵敏 王晓孟 王丹 王笑峰 徐琳)
参见：首页 > 医疗版 > 疾病专题 > 妇产科 > 子宫内膜异位症