宫腔镜辅助下阴道斜隔的诊治研究

Study on Hysteroscopy-assisted Diagnosis and Treatment of Oblique Vaginal Septum Syndrome

目的:探讨宫腔镜在阴道斜隔诊断和治疗中的临床应用价值。方法:回顾性分析2003年1月—2011年12月收治确诊为阴道斜隔的患者13例(Ⅰ型7例,其中1例伴先天性尿道阴道瘘,Ⅱ、Ⅲ型共6例),年龄11～20岁,平均(13.6±2.8)岁,因月经初潮后腹痛、周期性腹痛或发现盆腔包块入院,术前宫腔镜结合超声检查明确临床诊断,术中行宫腔镜检查生殖道发育情况、指导定位斜隔位置,行阴道斜隔切开及大部切除术,清除阴道或宫腔内的积血或积脓。结果:术后痛经症状均消失,经量无变化,无阴道或下腹包块再发。结论:宫腔镜是诊断阴道斜隔的重要手段,结合超声检查可明确生殖道发育情况并定位阴道斜隔位置,明确切开部位或指导手术切除。宫腔镜及超声监护可使阴道斜隔手术更准确、安全、快速。

Objective：To study the clinicle value of hysteroscopy in diagnosis and treatment of oblique vaginal septum syndrome.Methods：13 patients（7 cases of typeⅠ,1 cases with congenital urethrovaginal fistula,6 cases of type Ⅲ,Ⅱ） with oblique vaginal septum syndrome（OVSS） are enrolled from 2003 January to 2011 December.A systematic retrospective analysis,age 11-20 years old,average age is 13.6±2.8 years old,with abdominal pain after menarche,periodic abdominal pain or a pelvic mass was detected on admission,preoperative hysteroscopy combined with ultrasonography can make clear the clinical diagnosis.Hysteroscopy can find total reproductive development,guide and locate the septum position.Incision and resection of oblique vaginal septum,removal of vaginal or intrauterine hematocele or empyema.Results：Postoperative dysmenorrhea symptom disappeared,the volume no change,no vaginal or abdominal mass happened again.Conclusions：In diagnosis of oblique vaginal septum,hysteroscopy is an important means,combined with ultrasound examination to clearly understand reproductive development and localize of oblique vaginal septum position,guide operation resection or clear cut parts.By hysteroscopy and ultrasonography can make oblique vaginal septum operation more accurate,safe,fast,and direct.