国际妇产科学杂志

国际妇产科学杂志 ›› 2015, Vol. 42 ›› Issue (6): 648-650.

• 论著 • 上一篇    下一篇

生物补片法人工阴道成形术的临床应用初探

赵艳红，李留霞，张颖，赵艳萍，李娇娇，李灵燕，刘艳霞，郭瑞霞，边爱平，赵倩   

  1. 450052 郑州大学第一附属医院妇产科（赵艳红，李留霞，张颖，李娇娇，李灵燕，刘艳霞，郭瑞霞，边爱平，赵倩），超声科（赵艳萍）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-12-15 发布日期:2015-12-15
  • 通讯作者: 李留霞

Clinical Analysis of Acellular Dermal Matrix Vaginoplasty

ZHAO Yan-hong，LI Liu-xia，ZHANG Ying，ZHAO Yan-ping，LI Jiao-jiao，LI Ling-yan，LIU Yan-xia，GUO Rui-xia，BIAN Ai-ping，ZHAO Qian   

  1. Department of Obstetrics and Gynecology（ZHAO Yan-hong，LI Liu-xia，ZHANG Ying，LI Jiao-jiao，LI Ling-yan，LIU Yan-xia，GUO Rui-xia，BIAN Ai-ping，ZHAO Qian），Department of Ultrasound（ZHAO Yan-ping），The First Affiliated Hospital，Zhengzhou University，Zhengzhou 450052，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-12-15 Online:2015-12-15
  • Contact: LI Liu-xia

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摘要： 目的：探讨生物补片法人工阴道成形术治疗MRKH综合征（Mayer-Rokitansky-Kuster-Hauser syndrome）的临床应用价值。方法：回顾性分析2012年1月—2015年4月郑州大学第一附属医院42例MRKH综合征患者的临床资料，比较12例生物补片法人工阴道成形术（观察组）和30例腹腔镜腹膜代阴道成形术（对照组）的围手术期、术后并发症及术后随访情况。结果：42例患者手术均获成功，无脏器损伤发生。观察组的手术时间、术中出血量、肛门排气时间、术后总并发症发生率均低于对照组（P＜0.05），但住院费用高于对照组（P＜0.05）；术后随访2组的人工阴道长度均＞8 cm，宽度均容2指松，弹性良好。观察组术后3个月阴道腔表面完全黏膜化即可性生活，对照组完全黏膜化需要6个月，并且阴道炎症发生率高于观察组（P＜0.05）；女性性功能指数量表（FSFI）评分，2组各分项评分及总分比较差异均无统计学意义（P＞0.05）。结论：生物补片法人工阴道成形术与腹腔镜腹膜代阴道成形术均为安全有效的治疗MRKH综合征的方法，生物补片法手术更简便、创伤更小、并发症更少，术后性生活启动更早，是一种安全有效的新方法。

关键词: MRKH综合征, 生物补片, 阴道, 腹膜

Abstract: Objective：To investigate the feasibility of vaginoplasty with an acellular dermal matrix（ADM） patch in the treatment of Mayer-Rokitansky-Kuster-Hauser（MRKH） syndrome. Methods：The clinical data of 42 cases of congenital absence of vagina (MRKH syndrome) from January 2012 to April 2015 in our hospital were analyzed retrospectively，including 12 cases underwent ADM vaginoplasty（observer group） and 30 cases underwent laparoscopic peritoneal vaginoplasty（control group）. The perioperative, postoperative complications and postoperative follow-up data were compared between the two groups. Results：All cases were successful. No injury occurred arround the adjacent organs. The mean operation time，intraoperation blood loss，postoperative anal exhaust time and complications in observer group were less than that of control group（P＜0.05），while the hospitalization expenses in observer group was higher than that of control group（P＜0.05）. The follow-up showed that the width of artificial vagina of the two groups were 2 fingers in average and the length ＞8 cm with smooth and elastic mucosa. The vagina mucosa was formed 3 months in the observer group after vaginoplasty to start sexual life，while 6 months in the control group. The female sexual function index（FSFI） of the 8 cases in the observer group had no statistical difference with that of 16 cases in the control group（P＞0.05）. Conclusions：Both the ADM vaginoplasty and the laparoscopic peritoneal vaginoplasty are optimal procedures for vaginal reconstruction. However，the ADM vaginoplasty is simpler，less injury，fewer complications and earlier start sexual life.

Key words: Mayer-Rokitansky-Kuster-Hauser syndrome, Acellular dermal matrix patch, Vagina, Peritoneum