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目的:提高对男假两性畸形的诊断与治疗水平。方法:回顾2005年1月～2010年8月我院收治男假两性畸形患者10例,并结合文献对其病因、诊断、治疗进行讨论。结果:10例患者社会性别男4例,女6例,年龄2～21岁,平均18.5岁,入院后经体检,染色体核型,实验室检查,影像学及病理检查,确诊为男假两性畸形。其中8例接受手术治疗,2例术后性别为男性,6例术后性别为女性;2例放弃治疗出院。结论:男假两性畸形患者早期诊断对提高治疗效果至关重要,首选手术治疗,治疗应着重术后性别选择及性腺处理,术后性别的选择应根据患者的自身情况、意愿、心理、性取向,并结合家属意愿,患者所处周围环境、医生的技术水平等综合考虑,术后性别首选女性,应切除于所选性别相矛盾的性腺,以防恶变,术后予以相应的激素替代治疗。
Objective: To improve the diagnosis and treatment of male pseudohermaphroditism. Methods: From January 2005 to August 2010, 10 cases of male pseudohermaphroditism admitted to our hospital were retrospectively analyzed. The etiology, diagnosis and treatment of them were also discussed. Results: Among the 10 patients, there were 4 males and 6 females, ranging in age from 2 to 21 years (average 18.5 years). After admission, they were diagnosed as male pseudohermaphroditism by physical examination, chromosome karyotype, laboratory examination, imaging and pathological examination . Among them, 8 cases were treated surgically, 2 cases were male after operation, 6 cases were female after operation and 2 cases were given up for treatment. Conclusion: Early diagnosis of male pseudohermaphroditism is very important to improve the treatment effect. The first choice of surgical treatment should focus on gender selection and gonadal treatment. Postoperative gender selection should be based on the patient’s own condition, willingness, psychological, sexual orientation , Combined with the wishes of the families, the patient’s surroundings, the doctor’s skill level and other considerations, sex preferred female postoperative sex, should be removed in the selected gender contradictory gonads to prevent malignant transformation, postoperative hormone replacement therapy accordingly.