阴道斜隔综合征31例临床分析

Clinical analysis on 31 cases of oblique vaginal septum syndrome

目的:探讨阴道斜隔综合征的病理解剖特点、临床表现、诊断及治疗。方法:回顾分析2009年1月至2014年12月我院收治的31例阴道斜隔综合征患者的临床资料,其中Ⅰ型15例,Ⅱ型15例,Ⅲ型1例,包括临床表现、辅助检查、治疗方法及预后,术后随访1年~6年。结果:Ⅰ型患者就诊年龄为(13.07±1.58)岁,86.7%于初潮半年内就诊,均以痛经为首诊就诊原因;Ⅱ、Ⅲ型患者平均就诊年龄(25.20±7.09)岁,54.5%在性生活后半年内发病,62.5%以阴道流血流液流脓为首诊就诊原因。所有患者均有阴道壁囊肿,Ⅰ型直径大于Ⅱ、Ⅲ型患者;93.5%的患者合并肾脏缺如,以右肾为主。超声诊断率93.5%,磁共振诊断率100%。31例患者均采用阴道斜隔切除术,术后阴道不规则流血流液、腹痛等症状明显缓解或消失,术后均无阴道粘连发生,有生育要求的患者中71.4%成功受孕。结论:不同分型的阴道斜隔综合征患者临床表现各异,肾脏缺如可对阴道斜隔综合征患者起到提示作用,超声及磁共振检查可以帮助明确诊断。阴道斜隔切除术是有效的治疗方法,早期的诊断及治疗可以明显缓解患者症状,预防生殖系统疾病,保护患者生育功能。

Objective: To explore the pathological characteristics,diagnosis and the treatment of oblique vaginal septum syndrome. Methods: The clinical data such as clinic features、assistant examinations、treatment and prognosis of 31 cases diagnosed as oblique vaginal septum syndrome from Jan. 2009 to Dec. 2014 in our hospital were analyzed retrospectively,including 15 cases of type Ⅰ,15 cases of type Ⅱ and one case of type Ⅲ. All cases were follow-up visit from one year to six year after surgery. Results: The average visiting age of the type Ⅰ patients was( 13. 07 ± 1. 58) and 86. 7 percent of them was onset after menophania for half a year. All patients of type Ⅰ came to hospital for dysmenorrhea in the first time. The average visiting age of the type Ⅱ and Ⅲ patients was( 25. 20 ±7. 09) and 62. 5 percent of them came to the hospital in the first time for vaginal bleeding or vaginal fluid. 54. 5 percent of them was onset after sexual life for half a year. All of the patients with this disease had cyst at the vaginal wall,the diameter of the type Ⅰ was bigger than the type Ⅱ and Ⅲ. In addition,93. 5 percent of the patients had absence of the kidney,mostly the right one. The diagnosis of this disease by ultrasound was 93. 5%,while the MRI was 100%. The symptoms of vaginal bleeding or fluid and abdominal pain relieved or disappeared after they received vaginal septum resection. After the surgery,no vaginal adhesion happened,and 71. 4% of the women who had the desire of fertility were pregnancy successfully. Conclusion: The clinical manifestation of the different type of the patients were varied from each other. Lack of the kidney in female patients may remind us of the oblique vaginal septum syndrome. Ultrasound and MRI in diagnosis were helpful,vaginal septum resection was effective for the patients. Early diagnosis and therapy can relieve the patients’ clinic symptoms obviously,prevent them from reproductive system diseases and protect their fertility function.