球体替代纽扣改良腹腔镜Vecchietti阴道成形手术12例临床分析
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摘要
目的:探讨用球体替代纽扣实施腹腔镜Vecchietti阴道成形手术的可行性和临床效果的优越性。方法:选取2003年至2012年在山东大学齐鲁医院妇科行腹腔镜Vecchietti阴道成形术的20例先天性无阴道患者,其中行传统腹腔镜Vecchietti阴道成形手术者8例(纽扣组),用球体替代纽扣实施改良腹腔镜Vecchietti阴道成形手术者12例(球体组)。比较两组的手术时间、术中出血量、术后提拉疼痛评分,以及术后3月及6月的阴道长度(cm)和宽度(cm)。结果:球体组的手术时间、术中出血量、术后疼痛评分(VAS)均显著低于纽扣组(P<0.05)。术后3月及6月复查,两组患者的阴道长度及宽度均无显著差异(P>0.05)。结论:应用球体替代纽扣改良腹腔镜Vecchietti阴道成形手术与传统腹腔镜Vecchietti阴道成形手术相比较,缩短了手术时间,减少术中出血量,明显缓解患者术后提拉疼痛,同时又保留传统手术方式的优点,是一种创伤更小、更加简约可行的手术方式。
Objective: To discuss the improved laparoscopic Vecchietti vaginoplasty alternative by bead and to study its clinical effect.Methods: Twenty patients with vaginal agenesis(Mayer-Rokitansky-Kuster-Hauser syndrome) were reviewed,including twelve patients carried out by improved laparoscopic Vecchietti vaginoplasty alternatived by bead(the improved group)and eight by traditional laparoscopic Vecchietti vaginoplasty(the traditional group).The operation time,the amount of bleeding,the length and width of neovagina after three months and six months of the operation and the VAS score of operation were compared between the two kinds of operations.Results: The mean operating time and the average amount of bleeding and the VAS score of the two teams were distinguishing,the improved group was better(P<0.05).Whatever,the length and width of neovagina after three months and six months of the operation were not different(P>0.05).Conclusions: Compared the operation of improved laparoscopic Vecchietti vaginoplasty alternatived by bead with the traditional laparoscopic Vecchietti vaginoplasty,the former not only have the advantage of the traditional laparoscopic Vecchietti vaginoplasty,that is the neovagina is close to natural vagina both functionally and anatomically,but also have its own advantage that is the shorter operating time,the less amount of bleeding and it can relief the ache after the operation obviously. In conclusion,the improved laparoscopic Vecchietti vaginoplasty alternatived by bead promises to be a widely used and minimally invasive operation of vaginoplasty.
Objective: To discuss the improved laparoscopic Vecchietti vaginoplasty alternative by bead and to study its clinical effect.Methods: Twenty patients with vaginal agenesis(Mayer-Rokitansky-Kuster-Hauser syndrome) were reviewed,including twelve patients carried out by improved laparoscopic Vecchietti vaginoplasty alternatived by bead(the improved group)and eight by traditional laparoscopic Vecchietti vaginoplasty(the traditional group).The operation time,the amount of bleeding,the length and width of neovagina after three months and six months of the operation and the VAS score of operation were compared between the two kinds of operations.Results: The mean operating time and the average amount of bleeding and the VAS score of the two teams were distinguishing,the improved group was better(P<0.05).Whatever,the length and width of neovagina after three months and six months of the operation were not different(P>0.05).Conclusions: Compared the operation of improved laparoscopic Vecchietti vaginoplasty alternatived by bead with the traditional laparoscopic Vecchietti vaginoplasty,the former not only have the advantage of the traditional laparoscopic Vecchietti vaginoplasty,that is the neovagina is close to natural vagina both functionally and anatomically,but also have its own advantage that is the shorter operating time,the less amount of bleeding and it can relief the ache after the operation obviously. In conclusion,the improved laparoscopic Vecchietti vaginoplasty alternatived by bead promises to be a widely used and minimally invasive operation of vaginoplasty.
引文
[1]丰有吉,沈铿.妇产科学[M].北京:人民卫生出版社,2011:380-381
[2]李晓敏,曹芹然.腹腔镜下改良式圆球单孔Vecchietti阴道成形术分析[J].现代中西医结合杂志,2011,20(32):4118-4119
[3]吴静,苏联珍,范引侠,等.6种阴道成形术疗效比较[J].西安医科大学报,2001,22(4):381-382
[4]曹泽毅.中华妇产科学[M].北京:人民卫生出版社,1996:1303-1313
[5]凌斌,孙敏文.腹腔镜下乙状结肠代阴道成形术的临床应用[J].中华妇产科杂志,2004,39(5):319-321
[6]田雪红,张智莹,吴姝媛,等.九种人工阴道成形术的远期效果评价[J].白求恩医科大学学报,2001,27(4):416-417
[7]王黎娜,郉玲玲.应用腹腔镜腹膜代阴道成型术治疗先天性无阴道[J].中华实用诊断与治疗杂志,2010,24(7):652-653
[8]李晓敏,曹芹然.腹腔镜下改良式圆球单孔Vecchietti阴道成形术分析[J].现代中西医结合杂志,2011,20(32)
[9]Fedele L,Busacca M,Candiani M,et al.Laparoscopic creation of a neovagina in Mayer-Rokitansky-Kuster Hauser syndrome by modification of Vecchietti's operation[J].Am J Obstet Gynecol,1994,171(1):268-269
[10]刘毅,杨红萍,苏志红,等.小阴唇瓣阴道成形术的方法改进[J].中国美容医学,2005.2(14):42-43
[11]张宁芝,谢志红,肖红.18例腹腔镜下改良Vechitti阴道成形术体会[J].中华整形外科杂志,2004,20(5):361-363
[12]Fedele L,Bianchi S,Berlanda N,et al.Laparoscopic creation of a neovagina with the laparoscopic Vecchietti operation:comparison of two instrument sets[J].Fertil Steril,2006,(86):429-432
[2]李晓敏,曹芹然.腹腔镜下改良式圆球单孔Vecchietti阴道成形术分析[J].现代中西医结合杂志,2011,20(32):4118-4119
[3]吴静,苏联珍,范引侠,等.6种阴道成形术疗效比较[J].西安医科大学报,2001,22(4):381-382
[4]曹泽毅.中华妇产科学[M].北京:人民卫生出版社,1996:1303-1313
[5]凌斌,孙敏文.腹腔镜下乙状结肠代阴道成形术的临床应用[J].中华妇产科杂志,2004,39(5):319-321
[6]田雪红,张智莹,吴姝媛,等.九种人工阴道成形术的远期效果评价[J].白求恩医科大学学报,2001,27(4):416-417
[7]王黎娜,郉玲玲.应用腹腔镜腹膜代阴道成型术治疗先天性无阴道[J].中华实用诊断与治疗杂志,2010,24(7):652-653
[8]李晓敏,曹芹然.腹腔镜下改良式圆球单孔Vecchietti阴道成形术分析[J].现代中西医结合杂志,2011,20(32)
[9]Fedele L,Busacca M,Candiani M,et al.Laparoscopic creation of a neovagina in Mayer-Rokitansky-Kuster Hauser syndrome by modification of Vecchietti's operation[J].Am J Obstet Gynecol,1994,171(1):268-269
[10]刘毅,杨红萍,苏志红,等.小阴唇瓣阴道成形术的方法改进[J].中国美容医学,2005.2(14):42-43
[11]张宁芝,谢志红,肖红.18例腹腔镜下改良Vechitti阴道成形术体会[J].中华整形外科杂志,2004,20(5):361-363
[12]Fedele L,Bianchi S,Berlanda N,et al.Laparoscopic creation of a neovagina with the laparoscopic Vecchietti operation:comparison of two instrument sets[J].Fertil Steril,2006,(86):429-432