中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2015年
4期
278-282
,共5页
先天畸形%苗勒管%腹腔镜检查%阴道%妇科外科手术%46,XX性发育障碍
先天畸形%苗勒管%腹腔鏡檢查%陰道%婦科外科手術%46,XX性髮育障礙
선천기형%묘륵관%복강경검사%음도%부과외과수술%46,XX성발육장애
Congenital abnormalities%Mullerian ducts%Laparoscopy%Vagina%Gynecologic surgical procedures%46,XX disorders of sex development
目的：比较腹腔镜Vecchietti与Davydov阴道成形术治疗先天性生殖道畸形Mayer-Rokitansky-Küster-Hauser（MRKH）综合征的临床效果。方法2010年1月至2013年12月，对28例MRKH综合征患者分别采用腹腔镜Vecchietti阴道成形术（Vecchietti组，n=13）与腹腔镜Davydov阴道成形术（Davydov组，n=15）治疗，对比分析两组患者的手术效果。结果两组患者的手术均获成功，成形的阴道柔软、润滑、有弹性、宽可容2指。Vecchietti组患者的手术时间为（39±7）min，术中出血量（21±6）ml，术后肛门排气时间（19±5）h，术后体温恢复正常时间（35±10）h，术后住院时间（7.5±0.9）d，术后阴道长度（8.8±0.5）cm，术后女性性功能指数量表（FSFI）评分（26.8±2.0）分。Davydov组患者的手术时间为（73±11）min，术中出血量（63±10）ml，术后肛门排气时间（28±6）h，术后体温恢复正常时间（46±10）h，术后住院时间（7.1±0.7）d，术后阴道长度（9.6±0.5）cm，术后FSFI评分（28.5±1.7）分。Vecchietti组的手术时间、术中出血量、术后肛门排气时间、术后体温恢复正常时间均小于Davydov组，两组分别比较，差异均有统计学意义（P<0.05）；但术后阴道长度及FSFI评分不及Davydov组（P<0.05）；两组术后住院时间无明显差异（P>0.05）。两组术中均无并发症发生，术后Davydov组有2例患者发生阴道息肉，8例出现疼痛，而Vecchietti组均有疼痛发生。结论腹腔镜Vecchietti与Davydov阴道成形术都具有简单、安全、有效的特点。相比之下，Vecchietti术式虽然更加快捷、微创，但术后疼痛更多见，且阴道长度及性生活满意度不及Davydov术式理想。
目的：比較腹腔鏡Vecchietti與Davydov陰道成形術治療先天性生殖道畸形Mayer-Rokitansky-Küster-Hauser（MRKH）綜閤徵的臨床效果。方法2010年1月至2013年12月，對28例MRKH綜閤徵患者分彆採用腹腔鏡Vecchietti陰道成形術（Vecchietti組，n=13）與腹腔鏡Davydov陰道成形術（Davydov組，n=15）治療，對比分析兩組患者的手術效果。結果兩組患者的手術均穫成功，成形的陰道柔軟、潤滑、有彈性、寬可容2指。Vecchietti組患者的手術時間為（39±7）min，術中齣血量（21±6）ml，術後肛門排氣時間（19±5）h，術後體溫恢複正常時間（35±10）h，術後住院時間（7.5±0.9）d，術後陰道長度（8.8±0.5）cm，術後女性性功能指數量錶（FSFI）評分（26.8±2.0）分。Davydov組患者的手術時間為（73±11）min，術中齣血量（63±10）ml，術後肛門排氣時間（28±6）h，術後體溫恢複正常時間（46±10）h，術後住院時間（7.1±0.7）d，術後陰道長度（9.6±0.5）cm，術後FSFI評分（28.5±1.7）分。Vecchietti組的手術時間、術中齣血量、術後肛門排氣時間、術後體溫恢複正常時間均小于Davydov組，兩組分彆比較，差異均有統計學意義（P<0.05）；但術後陰道長度及FSFI評分不及Davydov組（P<0.05）；兩組術後住院時間無明顯差異（P>0.05）。兩組術中均無併髮癥髮生，術後Davydov組有2例患者髮生陰道息肉，8例齣現疼痛，而Vecchietti組均有疼痛髮生。結論腹腔鏡Vecchietti與Davydov陰道成形術都具有簡單、安全、有效的特點。相比之下，Vecchietti術式雖然更加快捷、微創，但術後疼痛更多見，且陰道長度及性生活滿意度不及Davydov術式理想。
목적：비교복강경Vecchietti여Davydov음도성형술치료선천성생식도기형Mayer-Rokitansky-Küster-Hauser（MRKH）종합정적림상효과。방법2010년1월지2013년12월，대28례MRKH종합정환자분별채용복강경Vecchietti음도성형술（Vecchietti조，n=13）여복강경Davydov음도성형술（Davydov조，n=15）치료，대비분석량조환자적수술효과。결과량조환자적수술균획성공，성형적음도유연、윤활、유탄성、관가용2지。Vecchietti조환자적수술시간위（39±7）min，술중출혈량（21±6）ml，술후항문배기시간（19±5）h，술후체온회복정상시간（35±10）h，술후주원시간（7.5±0.9）d，술후음도장도（8.8±0.5）cm，술후녀성성공능지수량표（FSFI）평분（26.8±2.0）분。Davydov조환자적수술시간위（73±11）min，술중출혈량（63±10）ml，술후항문배기시간（28±6）h，술후체온회복정상시간（46±10）h，술후주원시간（7.1±0.7）d，술후음도장도（9.6±0.5）cm，술후FSFI평분（28.5±1.7）분。Vecchietti조적수술시간、술중출혈량、술후항문배기시간、술후체온회복정상시간균소우Davydov조，량조분별비교，차이균유통계학의의（P<0.05）；단술후음도장도급FSFI평분불급Davydov조（P<0.05）；량조술후주원시간무명현차이（P>0.05）。량조술중균무병발증발생，술후Davydov조유2례환자발생음도식육，8례출현동통，이Vecchietti조균유동통발생。결론복강경Vecchietti여Davydov음도성형술도구유간단、안전、유효적특점。상비지하，Vecchietti술식수연경가쾌첩、미창，단술후동통경다견，차음도장도급성생활만의도불급Davydov술식이상。
Objective To compare Vecchietti′s and Davydov′s laparoscopic techniques for vagino-plasty in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Methods From January 2010 to December 2013, 13 patients underwent the Vecchietti′s laparoscopic procedure (Vecchietti group), and 15 patients underwent the Davydov′s laparoscopic procedure (Davydov group). Intraoperative parameters and postoperative results were compared. Results Both of the two groups were successfully treated. The neovagina in both groups were wide with good elasticity, softness and smoothness. The operation time [(39± 7) versus (73 ± 11) minutes], the intraoperative blood loss [(21 ± 6) versus (63 ± 10) ml], the anal exsufflation time after surgery [(19 ± 5) versus (28 ± 6) hours] and the recovery period of body temperature after surgery [(35 ± 10) versus (46 ± 10) hours] of the Vecchietti group were less than those of the Davydov group (all P<0.05). But the neovagina length [(8.8±0.5) versus (9.6±0.5) cm] was shorter and the Female Sexual Function Index scale score [26.8 ± 2.0 versus 28.5 ± 1.7] was lower in the Vecchietti group than those in the Davydov group (all P<0.05). The postoperation hospital duration didn′t reached statistical difference between the two groups [(7.5 ± 0.9) versus (7.1 ± 0.7) days, P>0.05]. No intraoperative complication occurred. After surgery, 2 patients were found vaginal polyps and 8 patients were suffered from pain in the Davydov group, while all patients were suffered from pain in the Vecchietti group. Conclusions Both Vecchietti′s and Davydov′s laparoscopic techniques are simple, safe and effective surgical methods for vaginal reconstruction. In contrast, the Vecchietti′s procedure is more time efficient and minimally invasive, while the Davydov′s procedure can get less pain, longer vagina and higher sexual satisfaction.
