改良会阴H形切口在腹腔镜下腹膜阴道成形术中的应用  

USE OF PERINEAL H-SHAPED INCISION IN LAPAROSCOPIC PERITONEUM VAGINOPLASTY

作　　者：陈树波[1] 董丽霞[2] 

机构地区：[1]河北医科大学附属邢台市人民医院泌尿外科,河北邢台054001 [2]河北医科大学附属邢台市人民医院妇科,河北邢台054001

出　　处：《中国修复重建外科杂志》2013年第1期69-71,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨腹腔镜下采用改良会阴H形切口行腹膜阴道成形术的疗效。方法 2005年1月-2011年7月,收治先天性无阴道患者29例。年龄20～30岁,平均22.7岁。已婚2例,未婚27例。患者无阴道口或在相当于阴道外口处有一浅凹陷。B超示盆腔无子宫或始基子宫,双侧卵巢正常。腹腔镜下切取腹膜后,在尿道口与肛门间及两侧作H形切口行人工造穴,行腹膜阴道成形术。结果患者手术均顺利完成,手术时间平均130.5 min,术中出血量平均73.5 mL,术后切口均Ⅰ期愈合。患者均获随访,随访时间1～2年,平均1.5年。术后3个月患者阴道长度为8.2～10.5 cm,平均9.5 cm;阴道能容纳2指,阴道黏膜良好;阴道脱落细胞成熟指数为50.5%±9.3%;尿道口至阴道前壁间距为0.8～1.2 cm,平均1.0 cm。术后1年患者阴道长度为7.2～10.0 cm,平均9.3 cm;阴道能容纳2指;阴道脱落细胞成熟指数为58.6%±8.1%;尿道口至阴道前壁间距为0.9～1.3 cm,平均1.1 cm。术后已婚有性生活者性生活满意率为95%。结论腹腔镜下采用会阴H形切口行腹腔镜腹膜阴道成形术手术操作简便,术后疗效好。Objective To evaluate the use value of the perineal H-shaped incision in laparoscopic peritoneum vaginoplasty. Methods Between January 2005 and July 2011, 29 cases of congenital absence of vagina underwent laparoscopic peritoneum vaginoplasty. There were 2 married cases and 27 unmarried cases, with a mean age of 22.7 years （range, 20-30 years）. The patients had no vagina mouth or had a shallow depression. B ultrasound showed normal bilateral ovarian and no uterine or primordial uterus in the pelvic cavity. H-shaped incision was made between urethra and rectum for peritoneum vaginoplasty. Results All operations were successfully completed. The mean operation time was 130.5 minutes, and the mean blood loss was 73.5 mL. Primary healing of incision was achieved in all patients and no complication occurred. All the patients were followed up 1-2 years （mean, 1.5 years）. At 3 months after operation, the mean length of neovagina was 9.5 cm （range, 8.2-10.5 cm）; the neovagina could hold 2 fingers and the mucosa appeared so soft and smooth with normal lubrication; vaginal exfoliate cell maturation index was 50.5% ± 9.3% ; and the mean urethra-vaginal orifices spacing was 1.0 cm （range, 0.8-1.2 cm）. At 1 year after operation, the mean length of the neovagina was 9.3 cm （range, 7.2-10.0 cm）; the neovagina could hold 2 fingers; the vaginal exfoliate cell maturation index was 58.6% ± 8.1%; the mean urethra-vaginal orifices spacing was 1.1 cm （range, 0.9-1.3 cm）. The rate of sexual satisfaction was 95%. Conclusion Use of the H-shaped incision in laparoscopic peritoneum vaginoplasty is a preferred way to reconstruct vagina for simple operation and good effectiveness.

关 键 词：腹膜阴道成形术 会阴H形切口 腹腔镜 

分 类 号：R713.3[医药卫生—妇产科学]