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目的 比较不同手术方法治疗先天性无阴道的疗效。方法 2 87例先天性无阴道患者分别给予以下 6种手术方法 :①大腿内侧皮片移植法 (皮片组 ) 1 2 1例 ;②羊膜移植法 (羊膜组 )1 0 2例 ;③Vecchitti’s(提扣式 ) 5 3例 ;④胎儿皮肤移植法 (胎儿皮组 ) 3例 ;⑤盆腔腹膜移植法 (腹膜组 ) 3例 ;⑥压迫法 5例。随诊时间为术后 4月～ 1 5年。观察成功率、婚后性生活情况和心理状态。结果 手术成功率皮片组、羊膜组和Vecchitti’s分别为 1 0 0 % (1 2 1 / 1 2 1 )、98 0 % (1 0 0 /1 0 2 )和 96 2 % (5 1 / 5 3) ;有性高潮体验者分别为 0、4 8% (3/ 6 3)和 37 8(1 4 / 37) ;BDI≥ 2 1分者分别为 35 2 % (1 8/ 5 1 )、31 9% (2 0 / 6 3)和 2 4 3% (9/ 37)。结论 Vecchitti’s手术患者婚后性生活满意度较高 ,心理状态较好 ,是目前较理想手术式。
Objective To compare the efficacy of different surgical methods in the treatment of congenital non-vaginal. Methods Two hundred and eighty 87 cases of congenital absence of vagina were given the following six kinds of surgical methods: ① thigh medial skin graft (flap group) 121 cases; ② amniotic membrane transplantation (amniotic membrane group) 102 cases; ③ Vecchitti’s 5 cases of fetal skin grafting (fetal skin group); ⑤ pelvic peritoneal transplantation (peritoneal group) in 3 cases; ⑥ compression method in 5 cases. Follow-up time of 4 months to 15 years after surgery. Observe the success rate, marital status and psychological status. Results The successful rate of surgery was 100% (100%), 98% (100%) and 96% (5 1/53%) in the skin graft group, amniotic membrane group and Vecchitti’s group, ); Those with orgasm experienced were respectively 0,4 8% (3/6 3) and 37 8 (14/37); those with BDI ≥ 2 1 were 35 2% (18/5 1), 31 9% (20/6 3) and 24.3% (9/37). Conclusions Vecchitti’s surgical patients are more satisfied with their sexual life after marriage and have better psychological status. This is the ideal surgery type.