宫、腹腔镜联合诊治性腺发育不全6例报告

Clinical analysis of gonadal dysgenesis and treatment with hysteroscopy combined with laparoscopy:with a report of 6 cases

目的:探讨宫、腹腔镜联合诊治性腺发育不全的作用及性腺发育不全的镜下特点。方法:对6例性腺发育不全患者进行宫、腹腔镜检查及腹腔镜下切除的性腺病例资料进行分析。结果:6例均为女性外阴,含有Y染色体,性激素低,5例骨龄明显低于同龄,3例为xo/xy性腺发育不全,3例为xy单纯性性腺发育不全,性腺均位于腹腔内,5例宫腔镜下见有宫颈,2例合并腹股沟斜疝,1例因B超未见子宫外院诊为CAIS,1例xo/xy性腺发育不全者性腺合并性腺母细胞瘤(16.67%)。结论:宫、腹腔镜是鉴别性腺发育不全抑或性激素及功能异常较好的诊断手段,且腹腔镜下观察清晰,在镜下切除性腺组织简单易行,可防止性腺发生病变。

Objective：To explore the role of hysteroscopy combined with laparoscopy in diagnosis and treatment for gonadal dysgenesis,and analyzed the clinical feature of the disease observed during the operation.Methods：Six cases of gonadal dysgenesis underwent hysteroscopy combined with laparoscopy were collected and analyzed.Results：All of the 6 cases＇ vulva appeared female,contained Y chromosome,had lower sex homone level,and 5 cases bone ages were lower than the normal people of the same age,3 cases were xo/xy gonadal dysgenesis,the 3 cases were xy pure gonadal dysgenesis.All the gonads sited in abdomen.5 cases were found cervix through hysteroscopy.2 cases werer found indirect inguinal hernia,1 case was diagnosed CAIS in other hospital because the didn＇t find cervix through B ultrasound,1 case of xo/xy gonadal dysgenesis had gynand rab lastoma.Conclusions：Hysteroscopy combined with laparoscopy is an effective diagnostic tool for gonadal dysgenesis,and dysfunction of sex homones,and also can well observed the feature of gonadal dysgenesis.Gonadectomy can be performed easily by laparoscopy for the prevention of neoplasia.