不损伤粘膜阴道紧缩术的临床效果评估

Clinical efficacy of uninjured mucosa-vaginal contraction plastic surgery

目的 评估不损伤粘膜阴道紧缩整形术用于修复会阴、紧缩阴道的临床效果。方法 对 3 82例自觉阴道松弛或 (和 )会阴Ⅰ～Ⅱ度裂伤的患者施行不损伤粘膜阴道紧缩整形术 ,其中子宫良性疾病需行阴式子宫切除 95例。会阴皮肤 4-0可吸收线皮内缝合 2 44例 ,用 4-0丝线“8”字缝合 13 8例 ,术后 1、3、6个月复查切口愈合和性生活情况。结果 平均手术时间为 3 5min(3 0～ 45min) ,术中平均出血量为 5 0ml(4 0～ 60ml) ,无手术感染病例 ,术后阴道内无瘢痕 ,阴道后壁形成一皱襞 ,术后 1月复查会阴切口丝线“8字”单层缝合的较连续皮内缝合瘢痕小 ,术后 2个月性生活较前满意达94.76% (3 62 /3 82 )。结论 不损伤粘膜阴道紧缩整形术修复会阴、紧缩阴道、阴道内不遗留瘢痕 ,损伤少 ,感染率低 ,是自觉阴道松弛妇女改善性生活质量的理想方法。

Objective To evaluate the clinical efficacy of uninjured mucosa-vaginal contraction plastic surgery for repairing perineum and contracting vagina. Methods 382 patients with vaginal relax and stage Ⅰ～Ⅱ lacerated perineum had undergone unjured vaginal mucosa contraction plastic surgery. 95 of them with benign uterine disease needed to receive vaginal hysterectomy. The perineum skin of 244 patients were continously intradermiclly sutured with number 4-0 absorbable ligature, 138 of them were sutured with number 4-0 silk thread in the form of '8' shape. At the first, third and sixth months after the surgery, the incision healing and sexual life condition were examined. Results The mean operative time were 35 minutes (30～45minutes), the mean amount of bleeding during operation was 50ml (40～60ml), no operation infected cases, no scars in the vagina after operation, a plica was formed in posterior vaginal wall. In patients receiving '8' shape suture, the scars sizes were smaller than those in patients receiving continous intradermic suture. 2 months after surgery, 94.76% (362/382) patients felt that their sexual lives were more satisfactory than before. Conclusion The uninjured mucosa contraction plastic surgery in repairing perineum and contracting vagina had the characteristics of no scars left, slight injury and less infection rate. It is a satisfactory way to improve sexual life for women with vaginal relax.