CAJ | 학술논문

幼女和少女妇科疾病的诊治在以往是一个比较棘手的问题。由于其生理和解剖特点，加上受到传统观念的影响，在必须进行经阴道检查和手术时，处女膜就成为了妇科医生诊断和治疗的障碍。近年来妇科内镜技术的发展使宫腔镜成为诊治幼女和少女妇科疾病的重要手段。宫腔镜进入时无需使用拉钩过度牵拉阴道，可在不损伤处女膜的前提下通过尚未发育成熟的相对狭窄的阴道，帮助确立诊断并可进行治疗，因而可替代大部分传统的需用阴道窥器的经阴道检查和手术，其全程均在可视下操作所以更加安全。近年来，应用宫腔镜在不损伤处女膜的情况下诊治幼女和少女的妇科疾病已经成为一种趋势，但大多数相关报道还仅局限于个案报道和含有少量病例的临床研究。对评估应用宫腔镜进行阴道内镜和（或）宫腔镜检查或手术来诊治幼女和少女妇科疾病的可行性和有效性进行综述。
유녀화소녀부과질병적진치재이왕시일개비교극수적문제。유우기생리화해부특점，가상수도전통관념적영향，재필수진행경음도검사화수술시，처녀막취성위료부과의생진단화치료적장애。근년래부과내경기술적발전사궁강경성위진치유녀화소녀부과질병적중요수단。궁강경진입시무수사용랍구과도견랍음도，가재불손상처녀막적전제하통과상미발육성숙적상대협착적음도，방조학립진단병가진행치료，인이가체대대부분전통적수용음도규기적경음도검사화수술，기전정균재가시하조작소이경가안전。근년래，응용궁강경재불손상처녀막적정황하진치유녀화소녀적부과질병이경성위일충추세，단대다수상관보도환부국한우개안보도화함유소량병례적림상연구。대평고응용궁강경진행음도내경화（혹）궁강경검사혹수술래진치유녀화소녀부과질병적가행성화유효성진행종술。
The diagnosis and treatment of gynecological problems in pediatric and adolescent patients were challenging in the past. Due to its physiological and anatomical characteristics, a vaginal approach for the assessment of gynecological problems in these patients has always been a problem. Furthermore, when vaginal examination is needed, virginity might be a significant obstacle for the gynecologist in diagnosing and establishing the management. Recent advance in gynecological endoscopic procedure has made hysteroscopy a promising option in assessing gynecological disorders in these patients. Hysteroscope is a useful substitute for vaginoscopy and/or hysteroscopy in the exploration of the immature genital tract. It is a safe procedure because it can always be performed under visual control. The scope of the hysteroscope is advanced into the vagina without a speculum or tenaculum, so it can facilitate diagnosis and treatment of gynecological disorders in pediatric and adolescent patients with intact hymens, limited vaginal access, narrow vaginas. Recent studies have used a hysteroscope for vaginoscopy and hysteroscopy to diagnose and establish therapeutic management of pediatric and adolescent patients with gynecological problems without injury of the hymen in recent years, but most of these studies are limited in case report and small scale clinical research. This article evaluated the effectiveness and feasibility of the use of a hysteroscope for vaginoscopy and hysteroscopy in diagnosing and establishing therapeutic management of pediatric and adolescent patients with gynecological problems.