腹腔镜下腹膜代阴道成形术与羊膜代阴道成形术对患者围术期指标及美容效果的比较  

Comparison of the effect of laparoscopic peritoneal vaginoplasty and amnion vaginoplasty on the perioperative indexes and cosmetic effects

作　　者：朱万娇 梁燕 ZHU Wanjiao;LIANG Yan(Department of Gynecology,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Sciences,Xiangyang 441021,Hubei,China)

机构地区：[1]襄阳市中心医院(湖北文理学院附属医院)妇科,湖北襄阳441021

出　　处：《中国性科学》2020年第7期100-103,共4页Chinese Journal of Human Sexuality

摘　　要：目的观察腹腔镜下腹膜代阴道成形术与羊膜代阴道成形术对先天性无阴道(MRKH综合征)患者围术期指标及美容效果的影响。方法选取2013年10月至2018年10月湖北文理学院附属医院(襄阳市中心医院)诊治的80例MRKH综合征患者临床资料进行回顾性分析。根据治疗方式分为腹腔镜下腹膜代阴道成形术组(腹膜组,n=55)与羊膜代阴道成形术组(羊膜组,n=25)。比较两组患者围术期指标(手术时间、术中出血量、住院时间)差异。于术后6个月时观察阴道成形效果,评估患者美容效果满意度和性生活质量。结果腹膜组患者手术时间、术中出血量大于羊膜组,差异具有统计学意义(P<0.05);两组患者住院时间比较,差异无统计学意义(P>0.05)。术后6个月时,腹膜组患者阴道长度、阴道宽度大于羊膜组,阴道息肉、阴道狭窄发生率低于羊膜组患者,差异具有统计学意义(P<0.05)。腹膜组患者美容效果满意度高于羊膜组患者,差异具有统计学意义(P<0.05)。术后6个月时,两组FSFI性欲、性唤起、性高潮评分差异无统计学意义(P>0.05);腹膜组患者FSFI湿润度、性满意度、性交痛评分及总分高于羊膜组患者,差异具有统计学意义(P<0.05)。结论腹腔镜下腹膜代阴道成形术虽手术时间及术中出血量大于羊膜代阴道成形术,但其阴道成形效果优于羊膜代阴道成形术,患者对美容效果满意度高,性生活质量好,更具优势。Objective To observe the effects of laparoscopic peritoneal vaginoplasty and amnion vaginoplasty on perioperative indexes and cosmetic effects in patients with Mayer-Rokitansky-Küster-Hauser syndrome(MRKH syndrome).Methods The clinical data of 80 patients with MRKH syndrome in our hospital from October 2013 to October 2018 were retrospectively analyzed.According to the treatment methods,the patients were divided into laparoscopic peritoneal vaginoplasty group(peritoneal group,n=55)and amnion vaginoplasty group(amnion group,n=25).The differences in perioperative indexes(operative time,intraoperative blood loss,hospital stay)were compared between the two groups.The vaginoplasty effects were observed at 6 months after surgery,and the patient satisfaction towards cosmetic effects and the quality of sexual life were evaluated.Results The operative time and intraoperative blood loss in peritoneal group were larger than those in amnion group(P<0.05).There was no significant difference in the hospital stay between the two groups(P>0.05).At 6 months after surgery,the vaginal length and vaginal width in peritoneal group were larger than those in amnion group,and the incidence rates of vaginal polyps and vaginal stenosis were lower than those in amnion group(P<0.05),and the satisfaction towards cosmetic effects in peritoneal group was higher than that in amnion group(P<0.05).At 6 months after surgery,there were no significant differences in the scores of sexual desire,sexual arousal and orgasm of FSFI between the two groups(P>0.05).The scores of wetness,sexual satisfaction and sexual pain and total score of FSFI in peritoneal group were higher than those in amnion group(P<0.05).Conclusions Although the operative time and intraoperative blood loss in laparoscopic peritoneal vaginoplasty are greater than those in amnion vaginoplasty,the vaginoplasty effect is better,with high patient satisfaction towards cosmetic effects and better quality of sexual life.

关 键 词：先天性无阴道 腹膜代阴道成形术 羊膜代阴道成形 围术期指标 美容效果 性生活质量 

分 类 号：R714[医药卫生—妇产科学]