小阴唇皮瓣法治疗阴道闭锁(1)
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[摘要]目的:探讨小阴唇皮瓣法在先天性阴道闭锁的临床应用。方法:选择适宜的13例先天性阴道闭锁患者,根据阴道缺损的量设计应用部分或完全小阴唇皮瓣进行部分或全阴道再造。结果:所有手术获得成功,再造阴道均通畅,湿润,光滑有弹性,有功能性子宫的病人月经正常,性生活满意,并有3例获正常妊娠分娩。结论:选择小阴唇发育良好的病例应用小阴唇皮瓣法再造阴道,其方法简便,损伤小,无外显瘢痕,费用少,值得在临床选择推广应用。
[关键词]阴道闭锁;皮瓣;阴道成形术;小阴唇
[中图分类号]R713.3+1[文献标识码]A[文章编号]1008-6455(2010)07-0970-02
Treatment of congenital atresia of vagina with labia minor flap
WANG Bang-he,WANG Chun-lan,CAO Dong-sheng,DING Hao
(Department of Plastic Surgery,First Affiliated Hospital of Anhui Medical University,Hefei 230032,Anhui,China)
Abstract:ObjectiveTo explore the clinic application of labia minor flap for vagina reconstruction. Methods13 patients with congenital atresia of vagina have been treated with labia minor flap vaginoplasty. The size (degree) of vagina defect determines the employment of part or full labia minor flap. Their curative effects and follow-up results were analyzed.ResultsThe follow-up result from six months to sixty months post - operation showed all the operations were successful and the colpostenosis didn't appear in the end. The reconstructed vaginas were moist,elastic and smooth. The menstruation cycle was normal in patients with functional uterus. The couples have satisfactory sex life and 3 cases achieved normal pregnancy and delivery. Colpostenosis appeared in 2 patients due to disobey of medical orders on placing the vagina mold and received the second operation. With the vagina mold for 4-month after the 2nd operation, these 2 patients also got a satisfactory result.ConclusionsThe labia minor flap vaginoplasty to congenital atresia of vagina has a great value of application, with the advantages of simpleness,little injury, no scar of vulvar and lower cost.
Key words:congenital atresia of vagina; flap; vaginoplasty; labium minus
阴道闭锁是胚胎发育期双侧中肾旁管汇合后尾端与尿生殖窦相接处因各种病因发育停滞,未能贯通所致,分为完全阴道闭锁和部分阴道闭锁。完全阴道闭锁为阴道管腔完全闭锁,子宫和/或卵巢发育不良,无生育功能;部分阴道闭锁仅阴道中下段或下段闭锁,上段为正常阴道,子宫和卵巢发育良好,功能正常。1994年3月～2009年3月,笔者选择性应用该方法成功治疗先天性阴道闭锁患者13例,其中部分阴道闭锁11例和完全阴道闭锁2例。现报道如下。
1临床资料
1.1 年龄:患者年龄12～22岁,平均15岁。
1.2 临床症状及体征:临床表现为周期性腹痛而无月经来潮或应有月经来潮而没有,妇科检查第二性征明显,均无阴道,直肠指检可扪及囊性包块或未扪及正常子宫。
1.3 辅助检查:10例B型超声波检查,均发现盆腔液性包块及探及正常子宫、宫颈,1例未能明确予行MRI检查明确正常宫颈结构,2例B超检查提示为幼稚子宫,所有病例均有正常卵巢 ......
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