156例行阴道内镜诊治的幼女和青春期少女临床资料分析  

Clinical analysis for 156 cases of vaginoscopy in young girls and adolescent girls

作　　者：易水晶[1] 王晓霞 金琳 徐一民 曾飞[1] YI Shuijing;WANG Xiaoxia;JIN Lin;XU Yimin;ZENG Fei(Department of Gynecology,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院妇科

出　　处：《中南大学学报（医学版）》2019年第9期1030-1034,共5页Journal of Central South University ：Medical Science

摘　　要：目的:探讨阴道内镜诊治幼女及青春期少女阴道及子宫疾病的临床应用价值。方法:回顾性分析2000年2月至2017年8月期间156位接受阴道内镜诊治的幼女及青春期少女的临床资料及其预后。结果:37例幼女病例中,临床主诉最常见的为阴道出血[15例(40.5%)];其次为阴道内塞入异物[11例(29.7%)]、阴道分泌物异常[9例(24.3%)]、下腹痛[2例(5.4%)];最终确诊为阴道异物的有13例(35.1%)。119例青春期少女中,就诊的临床症状最常见的为月经异常或不规则阴道流血[90例(75.6%)];最终确诊为异常子宫出血-排卵障碍(abnormal uterine bleeding-ovulatory dysfunction,AUB-O)最常见[59例(49.6%)],其次为宫内膜息肉所致子宫异常出血(abnormal uterine bleeding-polyp,AUB-P)[16例(13.4%)],子宫内膜恶变和不典型增生所致子宫异常出血(abnormal uterine bleeding-malignancy and hyperplasia,AUB-M)[2例(1.9%)]和全身凝血相关疾病所致子宫异常出血(abnormal uterine bleeding-coagulopathy,AUB-C)[1例(0.8%)];生殖道畸形者有37例(31.1%)。156例患者均成功完成阴道内镜检查及操作,术后仅1例出现泌尿系统感染,无其他并发症发生,均未损伤处女膜。结论:对于幼女和青春期少女的阴道或子宫疾病,阴道内镜是一项安全、有效的诊治方式。有异常阴道分泌物和阴道流血等情况要酌情考虑使用阴道内镜进行诊治,以免延误病情。Objective:To investigate the clinical value of vaginal endoscopy in the diagnosis and treatment for vaginal and uterine diseases in young girls and adolescent girls. Methods:The clinical data of 156 young girls and adolescent girls treated with vaginoscopy from February 2000 to August 2017 were analyzed retrospectively. Results:Of the 37 cases of young girls,the clinical symptoms were the most common in vaginal hemorrhage,accounting for 40.5%(15 cases),the second one in vaginal foreign body,accounting for 29.7%(11 cases),the third one in abnormal vaginal secretion,accounting for 24.3%(9 cases), and the last one in low abdominal pain,accounting for 5.4%(2 cases).The final diagnosis of vaginal foreign body was 13 cases (35.1%).Of the 119 adolescent girls,the clinical symptoms of the visit were the most common in menstrual abnormalities or irregular vaginal bleeding,accounting for 75.6%(90 cases).The final diagnosis of abnormal uterine bleeding-ovulatory dysfunction was the most common with 59 cases (49.6%),following by 16 cases of abnormal uterine bleeding-polyp, 2 cases of abnormal uterine bleeding-malignancy and hyperplasia,and 1 cases of abnormal uterine bleeding-coagulopathy.There were 37 cases (31.1%) of reproductive tract malformation.All 156 patients successfully completed vaginal endoscopy and operation with only 1 case of urinary system infection.No other complications occurred and no damage in the hymen. Conclusion:Vaginal endoscopy is a safe,effective and near-noninvasive way for the diagnosis and treatment of vaginal or uterine diseases in young girls and adolescent girls.In the case of abnormal vaginal secretions and vaginal bleeding,it should be properly recommended to use the vaginal endoscopy for diagnosis and treatment.

关 键 词：阴道内镜 青春期 幼女 异常子宫出血 阴道异物 

分 类 号：R711[医药卫生—妇产科学]