三步切除法小阴唇-阴蒂包皮联合缩小整形术临床应用研究  

Composite labia minora and clitoral hood reduction using a simple three-step excision:a retrospective study

作　　者：康圆博 夏泽楠 龙笑[1] 马旭达 朱琳[1] Kang Yuanbo;Xia Zenan;Long Xiao;Ma Xuda;Zhu Lin(Department of Plastic and Aesthetic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100032,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院整形美容外科,北京100032

出　　处：《中华整形外科杂志》2022年第8期867-872,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨应用三步切除法对小阴唇-阴蒂包皮复合体进行联合缩小整形术的有效性及安全性。方法选择2017年5月到2021年11月中国医学科学院北京协和医学院北京协和医院整形美容外科收治的小阴唇及阴蒂包皮肥大患者临床资料。患者均接受三步切除法小阴唇-阴蒂包皮联合缩小整形术:(1)设计纵行梭形切口切除冗余的阴蒂外侧包皮;(2)应用黏膜瓣法切除小阴唇的肥大部分;(3)修剪小阴唇外侧面与阴蒂包皮交界处多余皮肤形成的三角瓣,并完成切口缝合。患者术后第1、7、10天门诊复查,此后进行门诊或网上随访,术后3个月通过网络发放满意度问卷调查,内容包括术后外形是否改观、术前不适是否改善、术后是否出现不适、性生活质量是否提高、患者对手术效果的总体评价,以及患者伴侣对手术效果的总体评价。结果共纳入295例患者,年龄9~52岁,平均29岁。按照所接受的手术方式,将患者分为单侧小阴唇肥大合并单侧阴蒂包皮肥大21例(7.1%),单侧小阴唇肥大合并双侧阴蒂包皮肥大12例(4.1%),双侧小阴唇肥大合并单侧阴蒂包皮肥大50例(16.9%),双侧小阴唇肥大合并双侧阴蒂包皮肥大212例(71.9%)。295例患者术后并发症发生率为3.4%(10/295),其中血肿8例,瘢痕增生伴明显疼痛1例,血供障碍1例,进行相应处理后,所有患者术后恢复良好。共获得219份术后3个月患者满意度调查问卷,76例失访,患者总体满意率94.5%(207/219)。结论三步切除法术前设计简单,可安全有效地进行小阴唇-阴蒂包皮复合体的联合缩小整形,手术并发症少,切口隐蔽,瘢痕轻微,患者满意度高。Objective To investigate the efficacy and safety of a simple three-step excision for combined reduction plastic surgery of labia minora clitoral hood complex.Methods We selected the clinical data of patients with labia minora and clitoral prepuce hypertrophy treated in the Department of Plastic and Aesthetic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,from May 2017 to November 2021.All the patients underwent composite labia minora and clitoral hood reduction using a simple three-step excision.In the first step,a longitudinal shuttle incision was designed to remove the redundant lateral prepuce of the clitoris;In the second step,the hypertrophic part of labia minora was removed by wedge resection;The third step was to trim the triangular flap formed by the excess skin at the junction of the labia minora and the clitoral hood,and then complete the incision suture.Patients were asked to return for examinations on days 1,7,and 10 postoperatively.After that,the patients were followed up in the outpatient department or online,and the satisfaction questionnaires were conducted.The contents included appearance improvement,preoperative symptom improvement,postoperative discomfort symptoms,sexual life quality,partner’s evaluation of surgical effect,and patient’s evaluation of surgical impact.Results A total of 295 patients were enrolled,with an average age of 29 years,ranged from 9 to 52 years old.Patients were divided into 4 categories according to the surgeries they received,including 21 patients(7.1%)with unilateral labia+unilateral prepuce hypertrophy,12 patients(4.1%)with unilateral labia+bilateral prepuce hypertrophy,50 patients(16.9%)with bilateral labia+unilateral prepuce and 212 patients(71.9%)with bilateral labia+bilateral prepuce hypertrophy.The incidence of complications was 3.4%(10/295),hematoma occurred in 8 cases,scar hyperplasia with obvious pain in 1 case,and blood supply disorder in 1 case.After the complementary treatments,all patients recovered well from surgeri

关 键 词：外科 整形 小阴唇 阴蒂包皮 肥大 阴唇整形术 

分 类 号：R713.2[医药卫生—妇产科学]