前庭黏膜扩张法在腹腔镜下Vecchietti阴道成形术中的临床应用分析  

The clinical application analysis of vestibular mucosal dilation in laparoscopic Vecchietti vaginoplasty

作　　者：王建锋 张帆 张超 张顺仓 WANG Jian-feng;ZHANG Fan;ZHANG Chao;ZHANG Shun-cang(Department of Gynecology and Obstetrics,Xi'an People's Hospital(Xi'an Fourth Hospital),Xi'an,Shaanxi 710004,China;不详)

机构地区：[1]西安市人民医院(西安市第四医院)妇产科,陕西西安710004 [2]西安市第九医院妇产科

出　　处：《中国妇幼保健》2023年第20期4043-4047,共5页Maternal and Child Health Care of China

基　　金：陕西省重点研发计划项目(2020SF-307)。

摘　　要：目的 探讨前庭黏膜扩张法在腹腔镜下Vecchietti阴道成形术中的临床应用效果。方法 选取2006年1月—2019年1月西安市人民医院收治的50例先天性无阴道无子宫患者为研究对象,其中30例在行腹腔镜下Vecchietti阴道成形术前行预处理,先采用顶压法阴道成形术使前庭黏膜面积扩大松弛,然后行腹腔镜下Vecchietti阴道成形术,为观察组,20例无预处理直接行腹腔镜下Vecchietti阴道成形术,为对照组。比较两组患者手术相关指标和术后随访情况。结果 两组患者年龄[观察组(24.76±2.67)岁,对照组(23.45±2.56)岁]、身高[观察组(160.20±5.10) cm,对照组(161.00±5.70) cm]、体质量指数[观察组(22.40±3.60) kg/m^(2),对照组(21.70±4.20) kg/m^(2)]及术前阴道深度[观察组(2.48±0.62) cm,对照组(2.52±0.54) cm]比较,差异均无统计学意义(t=1.73、3.26、1.34及0.97,均P>0.05),具有可比性。观察组患者手术时间[(25.46±4.29) h]、术中出血量[(7.70±1.87) ml]、术中副损伤发生率(0.00%)、术后提线次数[(2.76±0.73)次]、提线视觉模拟评分法(VAS)评分[(3.66±0.92)分]均低于对照组[(40.85±9.12) h、(11.10±3.34) ml、(15.00%)、(4.40±0.75)次及(7.08±1.46)分],差异均有统计学意义(t=-8.02、-4.60、2.42、-7.66及-10.16,均P<0.05);观察组患者出院时阴道深度[(10.83±1.11) cm]长于对照组[(8.80±1.06) cm],差异有统计学意义(t=6.44,P<0.05);两组患者出院时阴道宽度[观察组(3.63±0.29) cm,对照组(3.55±0.29) cm]比较,差异无统计学意义(t=0.91,P>0.05)。观察组患者术后1年尿道口内翻率(0.00%)低于对照组(10.00%),差异有统计学意义(t=3.21,P<0.05);观察组患者术后1年阴道深度[(10.47±1.14) cm]长于对照组[(8.90±1.25) cm],差异有统计学意义(t=4.58,P<0.05);两组患者术后1年阴道宽度[观察组(3.37±0.27) cm,对照组(3.58±0.29) cm]比较,差异无统计学意义(t=0.91,P>0.05)。术后1年女性性功能指数(FSFI)评分比较,观察组患者性满意Objective To explore the clinical effect of the dilatation of vestibular mucosal in laparoscopic Vecchietti vaginoplasty.Methods From January 2006 to January 2019,50 consecutive patients were diagnosed with vaginal agenesis in Xi'an People's Hospital.30 patients were pretreated by dilating their vestibular mucosal by themselves before laparoscopic vaginoplasty procedure as the observation group,and 20 patients underwent laparoscopic Vecchietti vaginoplasty without pretreatment as the control group.The operative data,complication rates,vaginal length during the follow-up period were compared.Results There was no significant difference between observation group and control group in the age[observation group(24.76±2.67)years old,control group(23.45±2.56)years old],height[observation group(160.20±5.10)cm,control group(161.00±5.70)cm],body mass index[observation group(22.40±3.60)kg/m^(2),control group(21.70±4.20)kg/m^(2)],preoperative vaginal depth[observation group(2.48±0.62)cm,control group(2.52±0.54)cm](t=1.73,3.26,1.34 and 0.97,P>0.05).The time of operation[(25.46±4.29)hours],the amount of intraoperative bleeding[(7.70±1.87)ml],the incidence of intraoperative injuries(0.00%),the times of thread lifting[(2.76±0.73)times]and the VAS score of thread lifting[(3.66±0.92)points]of patients in the observation group were less than that of patients in the control group[(40.85±9.12)hours,(11.10±3.34)ml,(15.00%),(4.40±0.75)times and(7.08±1.46)points],and the differences were statistically significant(t=-8.02,-4.60,2.42,-7.66 and-10.16,P<0.05).The vaginal depth[(10.83±1.11)cm]of patients in the observation group at discharge was higher than that of patients in the control group[(8.80±1.06)cm]and the difference was statistically significant(t=6.44,P<0.05);There was no significant difference in vaginal width between the two groups at discharge[(3.63±0.29)cm in the observation group and(3.55±0.29)cm in the control group](t=0.91,P>0.05).The rate of urethral orifice entropion in the observation group(0.00%)was

关 键 词：先天性无阴道 Vecchietti 阴道成形术 前庭黏膜扩张法 

分 类 号：R713.3[医药卫生—妇产科学]