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1、先天性宫颈闭锁的诊疗策略分析先天性宫颈闭锁的诊疗策略分析[摘要]目的:探讨先天性宫颈闭锁的术前评估、手术方案的选择及对术后的影响。方法:对2005至2008年收治的12例先天性宫颈闭锁患者的临床资料进行分析和评估,以探讨该疾病最佳的治疗方法。结果:12例患者的年龄13〜19岁,12例合并阴道闭锁,其中有4例合并子宫畸形,4例合并卵巢宫内膜囊肿。对5例患者行宫颈整形及阴道成形术,4例行子宫切除术,3例行子宫内膜切除术。结论:先天性宫颈闭锁的患者术前应尽早诊断,根据子宫内膜发育情况,仔细评估手术成功率及预后,选择个性化治疗方案,恢复生育功能,减少再手术的风险,术后应定期随访是
2、手术后成功的重耍环节。[关键词]先天性宫颈闭锁;整形术,卵巢宫内膜囊肿;子宫畸形[中国分类号]R713[文献标识码]A[文章编号]1008-6455(2010)05-0652-03ClinicalstudyofdiagnosisandtreatmentofcongenitalcervixatresiaCHENMing,LIUJian-hua,KANGJian,RUANZheng-yi,LULi-li(DepartmentofObstetricsandGynecology,AffiliatedNinthPeople'sHospital,SchoolofMedicine,Sh
3、anghaiJiaotongUniversity,Shanghai200011,China)Abstract:0bjectiveToinvestigatethepreoperativeevaluation,thechoiceofoperativeproceduresandsurgicaleffectsinthetreatmentofcongenitalcervicalatresia・MethodsThedataofdiagnosisandtreatmentin12casesofcongenitalcervicalatresia,from2005to2008,wereret
4、rospectivelystudied,inordertoapproachtheappropriatetreatmentforthecongenitalcervicalatresia・ResultsTheagesofthecasesrangedfrom13to19years・Allcasessufferedfromvaginalatresiaatonce・Amongthem4caseshaduterinemalformationand4ovarianchocolatecyst・5casesunderwentcervicalplasticandvaginalreconstr
5、uctiveprocedures,4vaginalreconstructionandhysterectomy,and3vaginalreconstructionandendometriumremova1.ConclusionsCongenitalcervicalatresiashouldbediagnosedasearlyaspossible・Acarefulevaluationofthecasesmustbemadebeforetheoperationsaccordingtotheendometrialdevelopingconditions,forthechoiceo
6、findividualplasticsurgicalprocedurestogethighersuccessrateandmoreprobablerecoveryofreproductivefunction.Thepostoperativemanagementandfollow-uparealsoimperativeforthesurgicalsuccess・Keywords:congeniLalcervicalatresia;plasticsurgery;ovarianchocolatecyst;uterinemalformation先天性宫颈闭锁是女性生殖器官在形成、
7、分化过程中,由于某些因素的影响,正常管道腔化受阻所致,如果同时伴有副中肾衍牛物发育不全或融合障碍,可致无子宫、无阴道、始基了宫或双了宫、鞍状子宫等发育异常,临床较罕见。目前的诊断主要根据Buttram的分类标准:部分或完全性宫颈闭锁合并先天性闭锁阴道或有阴道,了宫内膜有功能[1]。主要临床表现为原发性闭经和周期性下腹痛。及吋的诊断及选择合适的治疗方法对预后影响较大。先天性宫颈闭锁合并先天性阴道闭锁,要求保留生育功能的患者,处理尤为棘手。我院自2005年〜2008年共收治12例先天性宫颈闭锁合并先天性阴道闭锁患者,现将临床资料进