两性畸形患者的诊断治疗体会(附45例报告)

Experience in the diagnosis and treatment of hermaphroditism(report of 45 cases)

目的探讨两性畸形患者的诊断和治疗体会。方法回顾性分析中国医科大学附属盛京医院2010年1月至2018年4月收治45例两性畸形患者的资料,采用腹腔镜和膀胱镜对45例患者进行探查、性腺活检,切除矛盾性腺及内生殖管道,行睾丸固定术、阴道成形术。结果45例两性畸形患者均行膀胱镜探查,7例女两性畸形患者均行腹腔镜探查及性腺活检。最终社会性别18例为男性,27例为女性。术后1例外阴切口水肿、渗血,1例阴囊皮下渗血。结论对于两性畸形患者,应尽早诊治,合理选择性别并采取相应手术方式,必要时辅以激素替代治疗,效果较好。

Objective To investigate the experience in the diagnosis and treatment of hermaphroditism.Methods Retrospective analysis was performed on the data of 45 cases of hermaphroditism admitted to Shengjing Hospital of China Medical University from January 2010 to April 2018.Laparoscopy and cystoscope were used to examine and biopsy the gonadal glands,the contradictory gonadal glands and internal reproductive ducts were remove,and orchiopexy and vaginoplasty on 45 patients were performed.Results Cystoscopic exploration was performed in the all 45 cases of hermaphroditism,and laparoscopic exploration and gonadal biopsy were performed in all but 7 cases of female pseudohermaphroditism.Finally,18 cases were male and 27 were female.Postoperative complications:1 case of perineal incision edema,bleeding,1 case of subcutaneous hemorrhage of scrotum.Conclusions For the patients with hermaphroditism,it is necessary to make diagnosis and treatment as soon as possible,rationally choose gender and adopt corresponding surgies,supplemented by hormone replacement therapy when necessary,with better results.