58例先天性阴道发育异常临床分析

The clinical analysis of 58 patients undergoing congenital vaginal malformation

目的:探讨不同类型的先天性阴道发育异常的临床特点、诊断及治疗方法。方法:回顾性分析我院收治的58例阴道发育异常患者的病例资料。结果:58例阴道发育异常中,先天性无阴道16例(27.59%),阴道闭锁11例(18.97%),处女膜闭锁4例(6.90%),阴道横隔4例(6.90%),阴道纵隔13例(22.41%),阴道斜隔10例(17.24%)。临床表现为原发性闭经(53.45%)、下腹痛(48.28%)、不规则阴道出血(18.97%)、性生活困难(12.07%)等,常合并子宫畸形及肾脏发育异常。50例患者行宫腔镜、腹腔镜下检查或宫腹腔镜联合检查,并同时行手术治疗,手术效果满意。结论:阴道发育异常病变类型复杂,临床表现多样。阴道内镜检查对于无性生活的患者进行畸形排查更具优势,应用宫腹腔镜技术诊治阴道发育异常更微创、更易被患者接受。

Objectives： To investigate the clinical feature, diagnosis and treatment of congenital vaginal malformation. Methods： A retrospective study was carried out to analyze the clinical data of 58 patients with vaginal malformation in our hospital. Results： Among the 58 patients, there were 16 （27.59%） with congenital absence of the vagina,11（ 18.97% ） with vaginal atresia, 4 （6.90%） with imperforate hymen, 4 （6.90%） with transverse vaginal septum, 13 （22.41%） with longitudinal vaginal septum, and 10 （17.24%） oblique vagina[ septum. The clinical manifestations were primary amenorrhea （53.45%）, abdominal pain （48. 28% ）, abnormal bleeding （ 18. 97% ）, and difficulty sexual intercourse（ 12.07% ）. Congenital vaginal malformation was often associated with uterine malformation and urinary malformation and all the patients having received operations had good clinical outcomes. Conclusion： Congenital vaginal malformation is of complex types, and the clinical manifestations are variable. Vaginoscopy is especially fit for female having no sexual life to examine the gential tract of anomalies. Laparoscopy combined with hysteroscopy in diagnosis and treatment of congenital vaginal malformation is minimally invasive that is more acceptable for patients.