阴道成形术在雄激素不敏感综合征中的应用  

Application of vaginoplasty in androgen insensitivity syndrome

作　　者：黄志欣[1] 罗光楠[1] 廖莳[1] 杜敏[1] 

机构地区：[1]广东省深圳市罗湖人民医院妇产科,广东深圳518001

出　　处：《中国内镜杂志》2012年第3期255-258,共4页China Journal of Endoscopy

摘　　要：目的探讨阴道成形术在雄激素不敏感综合征患者中的应用价值。方法对10例阴道短浅需行阴道重建的雄激素不敏感综合征患者实施阴道成形术,包括顶压扩张法、腹腔镜腹膜阴道成形术及肠道阴道成形术。总结分析其手术情况及手术效果。结果顶压扩张法无手术创伤,需时长。4例腹腔镜腹膜阴道成形术手术时间(其中3例含性腺切除术)55～95 min,平均67.5 min。术中出血5～20 mL,平均16.3 mL。2例肠道阴道成形术手术中乙状结肠阴道成形术手术时间215 min,术中出血100 mL;回肠阴道成形术手术时间180 min,术中出血180 mL。6例均无手术并发症。术后定期回访,人工阴道深约8～13 cm,平均11 cm,可容2指,阴道黏膜光滑湿润,柔软有弹性,4例已有满意性生活。结论应根据病情选择适当的阴道重建术。顶压扩张法是首选的治疗方式。当无法达到满意效果时选择手术整形。和肠道阴道成形术比,腹腔镜腹膜阴道成形术简便、创伤小、出血少、康复快。术后阴道外观与功能接近正常的阴道,值得推广。【Objective】 To evaluate the value of vaginoplasty in cases of androgen insensitivity syndrome.【Methods】 Vaginoplasty including dilation treatment,laparoscopic peritoneum vaginoplasty and intestinal vaginoplasty was performed in 10 cases with short and blind vagina due to androgen insensitivity syndrome.The perioperative results,complications,anatomical and functional outcomes were analyzed.【Results】 Vaginal dilation treatment is a successful method of vaginal creation and avoids the risks of surgery.Laparoscopic peritoneum vaginoplasty was performed successfully for these 4 cases.The mean operative time was 67.5 minutes（range 55~95 minutes）.Average blood loss was 16.3 mL（range 5~20 mL）.Intestinal vaginoplasty was performed successfully for 2 cases.The operative time of sigmoid vaginoplasty was 215 minutes,and blood loss was 100 mL.The operative time of ileum vaginoplasty was 180 minutes.Blood loss was 80mL.No operative and postoperative complications were reported.The resultant neovagina＇s depths were 11 cm（range 8~13 cm）.The neovaginal introitus admitted two fingers in width in all patients.The mucosa was smooth,wet,soft and elastic.4 patients have satisfactory sexual intercourse.【Conclusion】 Vaginal dilation treatment should be the first choice of treatment.If unsuccessful,laparoscopic techniques offer good outcomes and quick recovery.Compared with intestinal vaginoplasty,laparoscopic peritoneum vaginoplasty is a simple,safe and satisfactory technique for management of blind vagina due to androgen insensitivity syndrome.

关 键 词：阴道成形术 腹腔镜腹膜阴道成形术 肠道阴道成形术 雄激素不敏感综合征 

分 类 号：R713.3[医药卫生—妇产科学]