脱细胞异体真皮与腹腔镜腹膜代阴道成形术临床分析  

Analysis of acellular dermal matrix vaginoplasty and laparoscopic peritoneal vaginoplasty

作　　者：张虹[1] 赵倩[1] 张斯淼[1] 朱长青[1] 李哲[1] 

机构地区：[1]郑州大学第一附属医院妇科,450052

出　　处：《中国实用医刊》2017年第13期8-11,共4页Chinese Journal of Practical Medicine

摘　　要：目的 探讨脱细胞异体真皮代阴道成形术和腹腔镜腹膜代阴道成形术的临床效果.方法 选取2010年1月至2015年1月行阴道成形术的先天性无阴道（MRKH）患者44例,其中21例行脱细胞异体真皮（ADM）代阴道成形术为ADM组,23例行腹腔镜腹膜代阴道成形术为腹膜组.比较两种术式手术指标及术后随访情况.结果 44例手术均成功,无中转开腹,无肠道、膀胱及尿道损伤.ADM组手术时间、术后肛门排气时间均低于腹膜组（P〈 0.05）,住院费用高于腹膜组（P〈 0.05）;两组术中出血量、术后住院时间、术后总并发症发生率及术后病率比较差异未见统计学意义（P〉0.05）.术后随访,人工阴道长度与宽度两组比较差异未见统计学意义（P〉0.05）;随访全程两组人工阴道黏膜呈粉红色,有皱襞、润滑、弹性好,外阴外观无改变;ADM组与腹膜组女性性功能指数量表（FSFI）总分比较差异未见统计学意义（P〉0.05）.结论 脱细胞异体真皮代阴道成形术和腹腔镜腹膜代阴道成形术均能达到治疗先天性无阴道的目的.脱细胞异体真皮代阴道成形术操作更简单、手术创伤更小、术后恢更复快,但费用较高.Objective To investigate the effect of acellular dermal matrix vaginoplasty and laparoscopic peritoneal vaginoplasty.Methods From January 2010 to January 2015, 44 patients with MRKH syndrome underwent vaginoplasty were selected, 21 cases were given acellular allogenic dermis vaginoplasty as ADM group, and 23 cases were treated by laparoscopic peritoneal vaginoplasty as peritoneal group.Two kinds of surgical operation index and postoperative follow-up were compared.Results Forty-four patients were operated successfully, None was converted to laparotomy, None of intestinal and bladder and urethra was damaged.Operation time, postoperative anal exhaust time of the ADM group were lower than those of the peritoneal group（P〈 0.05）, the cost of hospitalization expenses in ADM group was higher than that of the peritoneal group（P〈 0.05）.The intraoperation blood loss, postoperative date of hospitalization, perioperative complication rate and postoperative morbidity were compared between the two groups, the differences were not significant （P〉0.05）.Postoperative follow-up the length and width of the neovagina was compared between the two groups, the differences were not significant （P〉0.05）.The mucosa of neovagina was pink,plicated,lubricant and resilient throughout the whole stydy.The total score of FSFI was compared between two groups, the difference was not significant （P〉0.05）.Conclusions Both acellular dermal matrix vaginoplasty and laparoscopic peritoneal vaginoplasty can achieve the purpose of treatment of congenital absence of vagina.ADM vaginoplasty is more simple,more minimally invasive and faster recovery than laparoscopic peritoneal vaginoplasty, but cost is higher.

关 键 词：阴道成形术 脱细胞异体真皮 腹膜 性生活质量 

分 类 号：R713.3[医药卫生—妇产科学]