脱细胞异体真皮束带在改良阴道紧缩联合会阴撕裂伤修复术中的疗效研究  

Clinical Research of Acellular Dermal Matrix in Modified Vaginal Tightening Surgery Combined with Perineal Laceration Repair

作　　者：罗启林 文凤霞 晏青 王涛 毕胜 张家平 袁希 LUO Qilin;WEN Fengxia;YAN Qing;WANG Tao;BI Sheng;ZHANG Jiaping;YUAN Xi(Department of Plastic Surgery,Southwest Hospital,the First Affi liated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院(西南医院)整形外科,重庆400038

出　　处：《中国美容医学》2023年第1期19-22,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨脱细胞异体真皮束带在改良阴道紧缩联合会阴撕裂伤修复术中的临床应用效果。方法:在阴道内侧皮肤与黏膜交界处3点与9点方向做切口,进行阴道后壁前端从内向外多层次多隧道束带缝合固定,将阴道腔缩窄和阴道口收紧并加固盆底,重点矫正阴道外1/3松弛。在会阴体正中穿刺破皮,进行会阴浅横肌肌肉内“8”字缝合,利用真皮束带进行拉紧收拢,修复陈旧性会阴撕裂伤。结果:术后阴道腔直径及阴道口明显缩窄,会阴体高度增加,并完成37例1年时间随访,患者阴道敏感性增加,性生活满意度明显提高。结论:脱细胞异体真皮束带改良阴道紧缩术通过恢复阴道近口1/3段处的肌肉、肌腱的弹性和连续性,使会阴体结构回归至接近解剖原位,创伤小,恢复期短,维持时间长,术后疗效满意、效果良好,值得临床推广应用。Objective To investigate the clinical curative effect of acellular dermal matrix in modified vaginal tightening surgery combined with perineal laceration repair.Methods Maked the incision at the junction of skin and mucosa in the inner vagina at 3 and 9 o’clock.Sutured and fixed at the anterior end of the posterior wall of the vagina with multi-layer and multi-tunnel tunnels from the inside to the outside,to narrow the vaginal cavity,tighten the vaginal opening and strengthen the pelvic bottom,focus on the correction of vaginal relaxation of outside 1/3.Punctured the skin in the middle of the perineum and performing intramuscular“8”suture in the superficial transversals of the perineum,then using the acellular dermal matrix to tighten and fold to repair the old perineal laceration.Results The diameter of vaginal cavity and vaginal orifice were significantly narrowed after surgery,and the height of the perineum increases.We followed up 37 cases for one year and the patients reported an increase in vaginal sensitivity and a significant increase in sexual satisfaction.Conclusion Acellular dermal matrix in modified vaginal tightening surgery by restoring the elasticity and continuity of the muscles and tendons near the outside 1/3 of the vagina,getiing the perineal structure returned to the near anatomical position.It has the advantages of small trauma,short recovery period,long maintenance time,satisfactory postoperative effect and good effect,which is worthy of clinical promotion and application.

关 键 词：脱细胞异体真皮 改良阴道紧缩术 会阴撕裂伤修复 中重度阴道松弛 临床疗效 

分 类 号：R622[医药卫生—整形外科]