阴道内镜治疗12例青春期女性阴道斜隔综合征的临床研究  

Clinical study of vaginal endoscopy in the treatment of 12 adolescent females with oblique vaginal septum syndrome

作　　者：许锋[1] 王素敏[1] 贾雪梅[1] 顾小燕[1] XU Feng;WANG Sumin;JIA Xuemei;GU Xiaoyan(Gynecology Department,Women's Hospital of Nanjing Medical University/Nanjing Women and Children's Healthcare Hospital,Nanjing 210004,China)

机构地区：[1]南京医科大学附属妇产医院/南京市妇幼保健院妇科,江苏南京210004

出　　处：《临床医学研究与实践》2025年第7期86-89,共4页Clinical Research and Practice

摘　　要：目的探讨阴道内镜治疗青春期女性阴道斜隔综合征(OVSS)的有效性和安全性。方法回顾性分析2019年4月1日至2024年7月30日在我院宫腔镜科住院诊治的12例青春期OVSS患者的临床特征、手术治疗情况及术后随诊资料等。结果12例青春期OVSS患者中Ⅰ型、Ⅱ型各6例。Ⅰ型患者中有4例以周期性经期腹痛为主要临床表现,1例因排尿困难7 h急诊就诊,1例主诉外阴疼痛4 d就诊;6例Ⅱ型患者均以异常子宫出血为主要临床症状,伴有经期腹痛。12例患者术前疼痛视觉模拟法评分均为9分。子宫发育异常情况包括双子宫11例、子宫完全纵隔1例;12例患者均合并肾脏缺如。超声或MRI检查示Ⅰ型患者中有1例合并左侧输卵管扩张积血,1例合并右侧卵巢子宫内膜异位囊肿;Ⅱ型6例患者均无输卵管扩张或附件区囊性肿物。Ⅰ型和Ⅱ型患者的诊断年龄、初潮与发病年龄时间间隔、阴道斜隔隔后腔囊肿最大直径比较,差异无统计学意义(P>0.05)。所有患者均行阴道内镜下阴道斜隔切除术,术后痛经、异常子宫出血症状均明显改善。结论重视青春期女性OVSS的早期诊断;首选阴道内镜下阴道斜隔切除术治疗可明显缓解症状,有利于青春期女性生理及性心理的健康发展,保护生育能力。Objective To investigate the efficacy and safety of vaginal endoscopy in the treatment of oblique vaginal septum syndrom(OVSS)in adolescent female.Methods The clinical characteristics,surgical treatment and postoperative follow-up data of 12 adolescent OVSS patients who were hospitalized in the hysteroscopy department of our hospital from April 1,2019 to July 30,2024 were retrospectively analyzed.Results There were 6 cases of type Ⅰ and 6 cases of type Ⅱ in 12 adolescent OVSS patients.Among the patients with typeⅠ,4 cases had periodic menstrual abdominal pain as the main clinical symptom,1 case had an emergency visit due to dysuria for 7 h,and 1 case complained of vulvar pain for 4 d;all 6 patients with type Ⅱ had abnormal uterine bleeding as the main clinical symptom,accompanied by menstrual abdominal pain.The preoperative Visual Analogue Scale scores of 12 patients were 9 points.Abnormal uterine development included 11 cases of double uterus and 1 case of complete uterine septum;all 12 patients had renal agenesis.Ultrasound or MRI examination showed that in typeⅠpatients,1 case complicated with left fallopian tube dilatation and hemorrhage,and 1 case complicated with right ovarian endometriosis cyst;there were 6 cases of type Ⅱ patients without tubal dilatation or adnexal cystic mass.There were no significant differences in the age of diagnosis,the time interval between menarche and age of onset,and the maximum diameter of posterior vaginal septum cyst between type Ⅰ and type Ⅱ patients(P>0.05).All patients underwent vaginal endoscopic vaginal oblique septum resection,and postoperative dysmenorrhea and abnormal uterine bleeding symptoms significantly improved.Conclusion Attention should be paid to the early diagnosis of OVSS in adolescent female;the first choice of vaginal endoscopic vaginal oblique septum resection can significantly relieve symptoms,which is conducive to the healthy development of adolescent female's physiology and sexual psychology and the protection of fertility.

关 键 词：阴道斜隔综合征 Herlyn-Werner-Wunderlich综合征 阴道内镜 

分 类 号：R711.1[医药卫生—妇产科学]