Clinical Analysis Of 174 Cases Of Abdominal Wall Endometriosis After Cesarean Section

Purpose:To study the clinical manifestation,classification of abdominal wall endometriosis after cesarean section and its significance for surgical treatment.Methods:The clinical data of 174 cases of abdominal wall endometriosis after cesarean section from February 2010 to August 2017 in the Affiliated Hospital of Qingdao University were retrospectively analyzed and summarized.Clinical types were based on the degree of infiltration of nodules:within the abdominal wall fat(F1),within the rectus abdominis and its anterior sheath(F2),within the abdominal wall fat and the rectus abdominis and its anterior sheath(F3),within the rectus abdominis and its anterior sheath and the peritoneum(F4),within the abdominal wall fat,the rectus abdominis and its anterior sheath and the peritoneum(F5).In the clinical data of 174 cases,the clinical classification,anesthesia,operation time,and intraoperative bleeding were counted,and statistical methods were used to compare each other.Results:There was no significant difference in the age and the frequency of cesarean section of abdominal wall endometriosis patients.There was significant difference between the latent period of abdominal endometriosis and clinical classification.In 118 of the 174 cases,abdominal wall incision nodule was the first manifestation,and 56 cases of abdominal wall incision nodule pain was the initial symptom,and the pain of mass is periodically changed with menstruation.Abdominal wall incision mass at the left or right sides of the transverse incision accounted for 81.61%.166 cases with single nodule and 8 cases with multiple nodules.Hypoechoic nodules at the incision of the lower abdominal wall can be seen in all patients of ultrasound examination of abdominal wall,and the shape of the block is irregular,the boundary is unclear,and the blood flow signal is partly visible.Among the 174 cases F1 19cases F2 18cases F3 112cases F4 9cases F516cases.All patients undertook surgical treatment by excision of the lesion.Most patients of F1,F2 and F3 types adopted intravenous anesthesia,their operation time was relatively short and the bleeding is less during the operation.Most patients of F4 and F5 types adopted general anesthesia or epidural anesthesia,their operation time was relatively long and the amount of bleeding increased.There were significant differences in the ways of anesthesia,operation time and the amount of bleeding in each group(P<0.05).The size of the block is divided into 3 categories(mass diameter<2cm,2<mass diameter<4cm,mass diameter>4cm)according to the diameter.The larger the diameter of the block is,the longer the operative time is,the more bleeding volume is.The difference in operative time and intraoperative blood loss between each block diameter group is statistically significant(P<0.05)?Conclusions:The deeper the infiltration of endometrium nodules on the abdominal wall,the longer the incubation period is.Abdominal wall incision nodule was the main manifestation of abdominal wall endometriosis after cesarean section,and the masses were mainly located on both sides of the transverse incision of the abdominal wall and most of them with single nodule.Preoperative ultrasonography provides an important diagnostic basis.All patients undertook surgical treatment by excision of the lesion.The clinical classifications of abdominal wall endometriosis after cesarean section have a po stive guiding significance on the choice of anesthetic methods,the estimation of operative time and the amount of bleeding.The size of the mass of the mass has a certain significance for the operation time and the amount of bleeding during the operation.