罗湖Ⅱ式腹腔镜腹膜阴道成形术临床应用研究  

Study on the clinical application of Luohu type Ⅱ laparoscopic vaginoplasty with peritoneum

作　　者：李宝艳[1] 杜敏[1] 廖莳[1] 石瑾秋[1] 秦成路[1] 张娟娟[1] 余鸿标[1] 张可[1] 罗光楠[1] 

机构地区：[1]广东省深圳市罗湖区人民医院,518000

出　　处：《中国妇幼保健》2011年第11期1712-1715,共4页Maternal and Child Health Care of China

基　　金：深圳市科技局立项项目〔200204146〕

摘　　要：目的:探讨罗湖Ⅱ式腹腔镜腹膜阴道成形术治疗先天性无阴道综合征的临床应用价值。方法:采用罗湖Ⅱ式腹腔镜腹膜阴道成形术(以下简称罗湖Ⅱ式)对106例先天性无阴道综合征患者实施手术治疗,观察其治疗效果,并与15例经腹乙状结肠阴道成形术(以下简称结肠代阴道)进行比较。结果:罗湖Ⅱ式组手术时间(65.52±16.67)min,结肠代阴道组手术时间(202.01±18.60)min(P<0.05);罗湖Ⅱ式组术中出血量(26.98±15.04)ml,结肠代阴道组术中出血量(105.34±46.36)ml(P<0.05);罗湖Ⅱ式组术后肛门排气时间(14.32±9.52)h,结肠代阴道组术后肛门排气时间(40.45±10.02)h(P<0.05);罗湖Ⅱ式组住院天数(28.99±4.63)天,结肠代阴道组住院天数(25.45±7.43)天(P>0.05)。术后随访3～12个月,罗湖Ⅱ式组98例术后阴道深>9 cm,8例阴道深度为8 cm,均可容阴道窥器插入,阴道黏膜粉红色、湿润,弹性良好,有性生活81例,其中78例性生活满意,3例诉阴道较浅,12例阴道顶端息肉形成。结肠代阴道组术后阴道深>9 cm。术后有性生活15例,对性生活不满意3例,其原因阴道分泌物过多2例、阴道为肠管所替代产生厌恶感1例。结论:罗湖Ⅱ式腹腔镜腹膜阴道成形术具有手术操作更简便、创伤更小、术中出血少、不易损伤膀胱和直肠、不破坏外阴形态、术后康复快等优点,术后人工阴道在生理及解剖方面接近正常阴道,是目前最为理想的阴道成形术式,值得临床推广。Objective：To explore the clinical application value of Luohu type Ⅱ laparoscopic vaginoplasty with peritoneum in treatment of congenital absence of vagina. Methods：106 patients with congenital absence of vagina were treated with Luohu type Ⅱ laparoscopic vaginoplasty with peritoneum（Luohu type Ⅱ group）,the clinical efficacy was observed,then the results were compared with those of 15 patients treated with laparoscopic vaginoplasty with sigmoid colon（sigmoid colon group）. Results：The operation times in Luohu type Ⅱ group and sigmoid colon group were（65.52±16.67） minutes and（202.01±18.60） minutes,respectively,there was significant difference between the two groups（P〈0.05）.The amounts of blood loss during operation in Luohu type Ⅱ group and sigmoid colon group were（26.98±15.04） ml and（105.34±46.36） ml,respectively,there was significant difference between the two groups（P〈0.05）.The anal exhaust times after operation in Luohu type Ⅱ group and sigmoid colon group were（14.32±9.52） hours and（40.45±10.02） hours,respectively,there was significant difference between the two groups（P〈0.05）.The hospitalization times in Luohu type Ⅱ group and sigmoid colon group were（28.99±4.63） days and（25.45±7.43） days,respectively,there was significant difference between the two groups（P〈0.05）.After follow-up for 3～12 months after operation,the depth of artificial vagina of 98 patients in Luohu type Ⅱ group was more than 9 cm,the depth of artificial vagina of 8 patients in Luohu type Ⅱ group was more than 8 cm,a vaginal speculum could insert into the artificial vagina,the vaginal mucosa was pink,moist and elastic,81 patients had sexual activity,and 78 patients were satisfied with it,3 patients complained that the artificial vagina was shallow,polyps occurred on the top of artificial vagina of 12 patients.In sigmoid colon group,the depth of artificial vagina of all the patients was more than 9 cm,15 patients had sexual activity,and 3 patients we

关 键 词：先天性无阴道 阴道成形术 腹膜 腹腔镜 

分 类 号：R711.73[医药卫生—妇产科学]