东北地区女性生殖系统发育异常594例临床病例研究  

Clinical research of 594 cases female reproductive dysplasia in northeast area of China

作　　者：霍乃晨[1] 银铎[1] 张淑兰[1] 王宁[1] 李威[1] 肖倩[1] 

机构地区：[1]中国医科大学盛京医院,辽宁沈阳110004

出　　处：《安徽医药》2013年第9期1514-1517,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的分析女性生殖系统发育异常的临床特点,对于妊娠的影响及不同的影像学诊断准确率,以提高临床实际工作中对该类疾病的认知及诊疗。方法回顾性分析研究该院10年间(2002年9月—2012年9月)住院接受手术治疗的生殖系统发育异常的女性患者。结果 (1)594例患者共表现生殖器官发育异常类型774例次,在594名患者中生殖系统单器官发育异常为441人,占74.24%(441/594),有7人表现出3重器官发育异常,占1.18%(7/594);发育异常类型中子宫发育异常最多,占65.50%(507/774),输卵管发育异常、卵巢发育异常、宫颈缺如所占比例最小,各为0.13%(1/774);(2)就诊年龄最小者为出生后8个月,最大者为61岁,平均年龄26岁,中位年龄为34.5岁,年龄分布主要集中在青春期生育期,造成患者就诊较多的原因为腹痛20.03%(119/594),异常妊娠(反复自然流产、胚胎停止发育等)25.93%(154/594),原发不孕12.46%(74/594),原发闭经11.11%(66/594)等原因;(3)594例患者中有53例患者存在不同程度的泌尿系统发育异常,占8.92%(53/594),265位患者既往曾经历原发不孕、自然流产、胚胎停止发育、早产、胎死宫内或异位妊娠等不良孕产事件发生;(4)在现有的辅助检查技术中,超声有着不可替代的作用,甚至接近手术确诊率。在该研究中尤其在子宫发育异常中阳性率更是达到88.15%,但由于其显像技术的局限性,对于阴道发育异常,尤其是阴道纵隔、横隔、斜隔等阴道腔内发育异常,总检查阳性率较低,在检查阳性率上不如MRI具备准确性。结论在女性生殖系统发育异常中,各类子宫发育异常较为常见,其中纵隔子宫的发病率最高,生殖系统发育异常对于女性生育及精神心理影响重大,超声筛查法经济简便,可及时发现生殖系统的异常,及时治疗,根据异常类型采取个体化手术方案矫治,减少其对妊娠生理及心理造成的影响。Objective To analyze the distribution characteristics of the female reproductive system dysplasia,its clinical manifestation, the influence on pregnancy, different imaging diagnostic accuracy, in order to improve the clinical practice of cognition, diagnosis and treatment of this disease. Methods Retrospective analysis was made september of 10 years（2002.9 2012） in the hospital surgery patients with dys-plasia of female reproductive system. Results Of 594 cases 774 of patients exhibited reproductive organs dysplasia,441 had single organ dysplasia,accounted for 74.24% （441/594）. Seven exhibited triorgans dysplasia, accounting for 1.18% （7/594）. Dysplasia was mainly in uterus, accounting for 65.50% （507/774）. Dysplasia of fallopian tubes, ovaries dysplasia and cervical lack of proportion were not common, each accounting for 0.13% （1/774）. The youngest patient was 8 months after the birth, the oldest 61 years old,average age 26 years old, the median age 34.5 years. Age distribution mainly concentrated in the puberty growth period. The causes for visiting the doctor were mainly abdominal pain 20.03% （119/594）., abnormal pregnancy （repeated spontaneous abortion and embryo development stops, etc. ）,25.93% （ 154/594 ）, primary infertility 12.46% （74/594）, primary amenorrhea 11.11% （66/594） 53 patients had different degrees of urinary sys-tem dysplasia,with accounted for 8.92% （53/594）. 265 patients had experience of infertility, spontaneous abortion and embryo develop-ment stops, premature delivery ,fetal intrauterine and ectopie pregnancy and other adverse maternal events. Of the existing auxiliary examina-tion techniques,ultrasound played an irreplaceable role, which was even close to surgical diagnosis rate. In this research, especially in the dysplasia of uterus the positive rate was 88.15%, but because of the limitations of imaging technology, the positive rate for vagina mediasti-num,transverse vaginal dysplasia,such as isolation,inclined isolation was low,which is super

关 键 词：女性生殖系统发育异常 泌尿系统发育异常 

分 类 号：R711.1[医药卫生—妇产科学]