先天性宫颈闭锁诊疗策略分析.docVIP

先天性宫颈闭锁诊疗策略分析 　　[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,术后应定期随访是手术后成功的重要环节。 　　[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)05-0652-03 　　 　　Clinical study of diagnosis and treatment of congenital cervix atresia 　　CHEN Ming,LIU Jian-hua,KANG Jian,RUAN Zheng-yi,LU Li-li 　　(Department of Obstetrics and Gynecology, Affiliated Ninth Peoples Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200011,China) 　　 　　Abstract:ObjectiveTo investigate the preoperative evaluation, the choice of operative procedures and surgical effects in the treatment of congenital cervical atresia.MethodsThe data of diagnosis and treatment in 12 cases of congenital cervical atresia, from 2005 to 2008, were retrospectively studied, in order to approach the appropriate treatment for the congenital cervical atresia.ResultsThe ages of the cases ranged from 13 to 19 years. All cases suffered from vaginal atresia at once. Among them 4 cases had uterine malformation and 4 ovarian chocolate cyst. 5 cases underwent cervical plastic and vaginal reconstructive procedures, 4 vaginal reconstruction and hysterectomy, and 3 vaginal reconstruction and endometrium removal.ConclusionsCongenital cervical atresia should be diagnosed as early as possible. A careful evaluation of the cases must be made before the operations according to the endometrial developing conditions, for the choice of individual plastic surgical procedures to get higher success rate and more probable recovery of reproductive function. The postoperative management and follow-up are also imperative for the surgical success. 　　Key words:congenital cervical atresia; plastic surgery;ovarian chocolate cyst; uterine malformation 　　 　　先天性宫颈闭锁是女性生殖器官在形成、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