Clinical Analysis Of56Cases Of Cesarean Abdominal Wall Scar Endometriosis

Background and ObjectiveEndometriosis (endometriosis, EMT) is called endometriosis for short. It refers to the site of active endometrial tissue (glands and stroma) other than the endometrium. It’s a common disease for women of childbearing age, clinical manifestations are dysmenorrhea, chronic pelvic pain, menstrual abnormalities and infertility, for benign disease, but it has the performance of the aggressive biological behavior of malignant and benign cancer. The disease occurs in the ovaries, sacral ligament, the posterior wall of the uterus and serosa, uterus and rectum pouch rare, pelvic, abdominal wall incision cesarean section endometriosis is (Abdominal wall scar endometriosis, AWE) the special kind occurred in the cesarean section pelvic endometriosis.With the year-on-year increase in the rate of cesarean section, postoperative abdominal incision endometriosis prevalence rate has also been increased, and the typical clinical manifestations associated with the menstrual cycle abdominal cesarean section incision site pain mass, the menstrual period mass increases with pain, menstrual pain relief or disappearance of pain medications, physical therapy and antibiotic treatment of abdominal incision endometriosis ineffective, painful to the patient, to increase their psychological and economic burden. There is still the possibility of recurrence after surgical removal of lesions, postoperative additional drugs can prevent recurrence, at home and abroad there is no consensus. In this study, a retrospective analysis2002-2012Zhengzhou University Second Clinical College gynecological treated56cases of abdominal wall of cesarean endometriosis patients clinical data explore impact of the abdominal wall cesarean section endometriosis the occurrence and prognostic factors in order to provide a reference for the future how to reduce the incidence of endometriosis in the abdominal wall cesarean section.Methods and objectsDischarge diagnosis of abdominal wall the cesarean endometriosis patients clinical data describe clinical date statically. Analysis of the factors that may affect the occurrence of the disease, follow-up by outpatient.Twice a year, and followed up for two years. The follow-up included clinical symptoms inquiries, examination of department of gynaecology and ultrasound. The statistical analysis of the clinical data and follow-up application SPSS17.0software, count data using the chi-square test, simple linear regression, multiple linear regression, the measurement data using t test. Test alpha=0.05.Result1. Clinical data:All patients had full-term history of cesarean section and there is no history of pelvic endometriosis outside; without pelvic endometriosis in49cases, the history of the history of seven cases. Clinical symptoms from the previous cesarean section time interval is called the incubation period; latency and age were positively correlated (r=0.918, P=0.004); latency and nursing time was positively correlated (r=0.782, P=0.001); incubation period of menstruation was a positive correlation (r=0.898, P=0.002). After multiple linear regression analysis, factors into the regression model, only two factors menstruation and age, breast-feeding was kicked out of the model, including the model of the two variables F is equal to114.074, P=0.000, significant model, the regression equation was established, the model R2=0.811, age and menstruation explained81.1%of the variation of the incubation period, adjusted R2=0.804; regression equation is expressed as:=-30.403+3.448X1+1.083X2. X1the=of Menstruation, X2=Age.2. Age>35years of age (n=23) of patients and age a≤35-year-old patient (n=33) of the incubation period affected the difference was statistically significant (t=-2.707, P=0.009); feeding time>6months (24<6months) of patients and nursing time patients (n=32) of the incubation period affected the difference was statistically significant (t=-2.240, P=0.029); menstruation time>6months (24patientscases) and complex wave time to to≤6months (n=32) of the incubation period affected the difference was statistically significant (t=-3.261, P=0.002) in patients with.3. Treatment:All patients are carried out surgical treatment, cutting edge away from the lesion outside the1-2cm of the patients (33cases) and cutting edge from the outside of the lesion of0.5-lcm patients (23cases) the impact of differences in recurrence was significantly (P=0.037); excision of the lesion average size3.5cm (l-5cm), lesions>3cm of patients (n=37) and lesions≤3cm of the patients (19cases) the impact of differences in recurrence was significantly (P=0.036), surgery underwent drug adjuvant treatment of patients did not undergo drug treatment (n=24)(n=32) and postoperative risk factors for recurrence showed a significant difference (P=0.041).4. postoperative follow-up:the successful follow-up of53patients,11patients (20.1%) patients relapse, the relationship between pain and menstrual cycle significantly in9patients,8patients were recurrence did not undergo drug treatments.Conclusion1. The AWE incubation period and the patient’s age, breast-feeding time, the time of menstruation was positively correlated, age and menstruation explained81.1%of the variation of the incubation period, to extend the feeding time, to postpone menstruation can prevent the occurrence of the AWE.2. Surgical excision of the lesion is an effective way to treat AWE cutting edge is greater than the lesions outside1cm, the postoperative adjuvant drug treatment, can reduce the risk of recurrence.3. lesion size affects the the AWE recurrence, and the recurrence rate of the lesions>3cm is higher than the lesions≤3cm, suggesting that the disease should be treated as soon as possible.