长期留置儿童阴道异物1例并文献复习

A case of long-term indwelling of vaginal foreign bodies in a child and related literature review

目的总结分析儿童阴道异物的临床特征、误诊原因及防范措施。方法回顾性总结南昌大学第一附属医院高新医院儿科2020年12月收治的1例留置2年余儿童阴道异物的临床资料。以“儿童”和“阴道异物”为关键词在万方数据库、中国期刊全文数据库、中国维普数据库,以“vaginal Foreign body”或“Intravaginal foreign body”和“pediatric”或“children”为关键词在PubMed数据库检索1975年1月至2021年3月相关文献进行文献复习。结果患儿,女,5岁11月,因“反复外阴分泌物2年余,加重伴血性分泌物3月”入院。期间反复就诊于省内各级医疗机构,按“尿路感染、外阴炎”予各类口服或静脉抗生素治疗。入院妇科会诊怀疑阴道异物,全身麻醉下行宫腔镜检查,于阴道内取出一支笔帽,术后症状缓解,随访至2021年3月无不适。结论儿童阴道异物多见于幼少女,主要表现为阴道出血或阴道分泌物;临床上极易被漏诊误诊,若异物长期留置可造成严重并发症;家庭及学校应加强儿童早期性教育、关注儿童心理健康,预防其发生。

Objective To summarize and analyze the clinical characteristics,misdiagnosis reasons and preventive measures of vaginal foreign bodies in children.Methods The clinical data of a child with vaginal foreign bodies indwelled for more than 2 years who was admitted to the Department of Pediatrics,Gaoxin Hospital of the First Affiliated Hospital of Nanchang University in December 2020 was retrospectively summarized.Taking"children"and"vaginal foreign body"as key words,the search was conducted in Wanfang Database,Chinese Periodical Full-Text Database and China VIP Database.Taking"vaginal foreign body"or"intravaginal foreign body"and"pediatric"or"children"as key words,the related literature from January 1975 to March 2021 was searched in PubMed database for literature review.Results The patient,a female child,11 months past 5 years old,was admitted to the hospital for"recurrent vulvovaginal secretions for more than 2 years and exacerbated bloody secretions for 3 months".During this period,she repeatedly visited medical institutions at all levels in the province,and was treated with various oral or intravenous antibiotics against"urinary tract infection and vulvitis".After admission to our hospital,the patient received the gynecological consultation,in which vaginal foreign bodies were suspected.The patient then underwent a hysteroscopy under general anesthesia,during which a pen cap was removed from the vagina.After the operation,symptoms were relieved.The patient was followed up until March 2021,showing no discomfort.Conclusion Vaginal foreign body in children is more common in young girls,mainly manifested as vaginal bleeding or vaginal secretions;Clinically it is very easy for it to escape diagnosis or be misdiagnosed.If the foreign body is indwelled for a long time,it can cause serious complications.Families and schools should strengthen early childhood sex education and pay attention to children's psychological health,thus preventing s uch disease from happening.