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目的总结腹腔镜下改良Vechitti阴道成形术重建阴道的疗效。方法回顾分析2003年2月-2008年3月,采用腹腔镜下改良Vechitti阴道成形术治疗并获2年以上随访的32例先天性无子宫无阴道患者临床资料。患者年龄21～30岁,平均23岁。大小阴唇发育尚可,尿道口位于前庭高位,无阴道口或在相当于阴道外口处有一浅凹陷,有长0.5～2.5 cm的阴道盲端。B超检查示:30例盆腔内无子宫,2例为始基子宫;双侧卵巢正常。结果术后患者均获随访,随访时间2～5年,平均2.5年。术后2年时30例患者阴道深6～7 cm,可容纳2横指;2例离异患者因无规律性生活以及未间断佩带模型,重建阴道长度仅为4.0 cm及4.5 cm。阴道黏膜呈粉红色,质地柔软、光滑,无瘢痕,无阴道息肉样组织及黄色阴道分泌物。术后2年阴道脱落细胞成熟指数为61.2%±13.5%,与正常育龄妇女(72%)接近。结论腹腔镜下改良Vechitti阴道成形术重建阴道手术操作简便,疗效好。
Objective To summarize the curative effect of laparoscopic reconstruction of Vagina with modified Vechitti vaginoplasty. Methods The clinical data of 32 patients with congenital absence of the uterus who underwent laparoscopic vaginoplasty and were followed up for more than 2 years from February 2003 to March 2008 were retrospectively analyzed. Patients aged 21 to 30 years, mean 23 years old. Size labia development can still, the urethra in the vestibular high, no vaginal mouth or vaginal mouth at the equivalent of a shallow depression, a long 0.5 ~ 2.5 cm of the vaginal blind end. B-ultrasound showed: 30 cases of pelvic uterus, 2 cases of primordial uterus; bilateral ovarian normal. Results All patients were followed up for 2 to 5 years with an average of 2.5 years. At 2 years after operation, 30 patients had a deep vagina of 6-7 cm, which could accommodate 2 transverse fingers. Two cases of divorced patients were reconstructed with only 4.0 cm and 4.5 cm vaginal length due to irregular life and uninterrupted wearing model. Vaginal mucosa was pink, soft texture, smooth, no scars, no vaginal polyps and yellow vaginal secretions. The maturation index of vaginal exfoliated cells at 2 years after operation was 61.2% ± 13.5%, which was close to that of normal women of childbearing age (72%). Conclusion Laparoscopic reconstruction Vechitti vaginoplasty reconstruction of vaginal surgery is simple and effective.