阴道斜隔综合征81例误诊分析

Misdiagnosis analysis on 81 cases of vaginal oblique diaphragm syndrome

目的 探讨阴道斜隔综合征的特征,以提高其诊出率。方法 回顾分析81例阴道斜隔综合征(HWWS)患者的临床资料,总结其特征及误诊原因。结果 HWWSⅠ型患者20例(24.69%),Ⅱ型患者33例(40.74%),Ⅲ型患者25例(30.87%),3例(3.70%)为无孔斜隔合并一侧子宫颈粘连闭锁型。所有患者均伴有斜隔侧的肾缺如。Ⅰ型患者以腹痛和盆腔包块为就诊主要原因,Ⅱ、Ⅲ型患者以月经异常、异常阴道流液或流脓及不孕为主要就诊原因。盆腔超声联合MRI检查检出率可达100%。结论 阴道斜隔综合征的子宫畸形表现为多样性,且临床表现也各异,泌尿系统异常发育异常有助于协助诊断阴道斜隔综合征,超声联合盆腔MRI检查可以帮助明确诊断。

Objective To explore the clinical characteristics of oblique vaginal septum syndrome(OVSS)and to improve the detectable rate of OVSS.Methods Clinical data of 81 patients with OVSS were retrospectively analyzed, and its general conditions, clinical manifestations and misdiagnosis were summarized.Results There were 20 cases(24.69%) with type Ⅰ OVSS,33 cases(40.74%) with type Ⅱ OVSS and 25 cases(30.87%) with type Ⅲ OVSS,and three cases(3.70%) had an oblique nonporous septum combined with atresia of cervical adhesions on one side. All patients had renal absence on the oblique side. Abdominal pain and pelvic mass were considered to be main reasons for treatment of type I OVSS patients, and irregular menstruation, abnormal vaginal discharge or suppuration and infertility were main reasons for treatment of type Ⅱand Ⅲ patients. The sensitivity of pelvic ultrasonography combined with MRI approaches was 100%.Conclusion Clinical manifestations of different types of OVSS,and may be manifested as other uterine malformations. Absence of the kidney can be a reminder for patients with OVSS. The ultrasonography and magnetic resonance imaging can help confirm the diagnosis.