蚌埠医学院学报
蚌埠醫學院學報
방부의학원학보
ACTA ACADEMIAE MEDICINAE BENGBU
2014年
6期
735-737,738
,共4页
阴道成形术%先天性无阴道%改良
陰道成形術%先天性無陰道%改良
음도성형술%선천성무음도%개량
vaginoplasty%congenital absence of vagina%improvement
目的：对比阴股皮瓣移植人工阴道成形术及经Retzius间隙改良Vechietti阴道成形术的临床应用价值，探讨经Retzius间隙改良Vechietti阴道成形术的穿刺路径和手术安全性。方法：对18例先天性无子宫无阴道患者行阴道成形术，其中阴股皮瓣移植人工阴道成形术(皮瓣移植组)9例，经Retzius间隙改良Vechietti阴道成形术(改良组)9例。比较2组手术时间、出血量、住院时间、手术并发症及术后效果。结果：18例手术均获成功，皮瓣移植组术后随访8例，失访1例，随访时间3个月至2年，术后外阴形态轻度改变，有1例人工阴道继发感染；改良组9例术后均随访，随访时间4个月至2.5年，术后外阴形态无改变，无1例并发症发生。两种方法成形术后阴道宽度及深度均满意，黏膜润滑、弹性可，已婚者性生活满意。改良组手术时间短，出血量少，住院时间短，与皮瓣移植组比较差异均有统计学意义(P<0.01)。结论：经Retzius间隙改良Vechietti阴道成形术更趋微创、操作简单，对患者损伤更小。只要掌握手术技巧，该术式是安全的，值得临床推广。
目的：對比陰股皮瓣移植人工陰道成形術及經Retzius間隙改良Vechietti陰道成形術的臨床應用價值，探討經Retzius間隙改良Vechietti陰道成形術的穿刺路徑和手術安全性。方法：對18例先天性無子宮無陰道患者行陰道成形術，其中陰股皮瓣移植人工陰道成形術(皮瓣移植組)9例，經Retzius間隙改良Vechietti陰道成形術(改良組)9例。比較2組手術時間、齣血量、住院時間、手術併髮癥及術後效果。結果：18例手術均穫成功，皮瓣移植組術後隨訪8例，失訪1例，隨訪時間3箇月至2年，術後外陰形態輕度改變，有1例人工陰道繼髮感染；改良組9例術後均隨訪，隨訪時間4箇月至2.5年，術後外陰形態無改變，無1例併髮癥髮生。兩種方法成形術後陰道寬度及深度均滿意，黏膜潤滑、彈性可，已婚者性生活滿意。改良組手術時間短，齣血量少，住院時間短，與皮瓣移植組比較差異均有統計學意義(P<0.01)。結論：經Retzius間隙改良Vechietti陰道成形術更趨微創、操作簡單，對患者損傷更小。隻要掌握手術技巧，該術式是安全的，值得臨床推廣。
목적：대비음고피판이식인공음도성형술급경Retzius간극개량Vechietti음도성형술적림상응용개치，탐토경Retzius간극개량Vechietti음도성형술적천자로경화수술안전성。방법：대18례선천성무자궁무음도환자행음도성형술，기중음고피판이식인공음도성형술(피판이식조)9례，경Retzius간극개량Vechietti음도성형술(개량조)9례。비교2조수술시간、출혈량、주원시간、수술병발증급술후효과。결과：18례수술균획성공，피판이식조술후수방8례，실방1례，수방시간3개월지2년，술후외음형태경도개변，유1례인공음도계발감염；개량조9례술후균수방，수방시간4개월지2.5년，술후외음형태무개변，무1례병발증발생。량충방법성형술후음도관도급심도균만의，점막윤활、탄성가，이혼자성생활만의。개량조수술시간단，출혈량소，주원시간단，여피판이식조비교차이균유통계학의의(P<0.01)。결론：경Retzius간극개량Vechietti음도성형술경추미창、조작간단，대환자손상경소。지요장악수술기교，해술식시안전적，치득림상추엄。
Objective:To compare the clinical value of the artificial vaginoplasty with pudendal-thigh skin flap transplantation and modified Vechietti vaginoplasty through Retzius gap,and explore the latter puncture path and safety. Methods:Eighteen patients with congenital absence of uterus and vagina were treated with vaginoplasty using pudendal-thigh skin flap transplantation ( skin flap transplantation group,9 cases) and modified Vechietti vaginoplasty through Retzius gap( modified group,9 cases) . The operation time, blood loss, hospital stay, complications and postoperative effects between two groups were compared. Results:All operations were successful. In skin flap transplantation group,except for 1 case lost following-up,8 cases were followed up for 3 months to 2 years. Mild vulvae shape change and 1 case with artificial vagina secondary infection in skin flap transplantation group were found. The modified group were followed up for 4 months to 2. 5 years,no vulvae shape change and complications were found. The appropriate width and depth of vagina,lubricated and elastic mucosa and harmonious sexual life in two groups were confirmed. Compared with the skin flap transplantation group,the shorter operation time,less blood loss and shorter hospital stay were found in modified group,the differences of two groups were statistical significance(P<0. 01). Conclusions:The modified Vechietti vaginoplasty through Retzius gap is minimally invasive,simple and safe,which is worth clinical promotion.
