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先天无阴道 有子宫,人工子宫脱垂阴道成型的安太疗法 Antai therapy for vaginal formation without congenital vagina, artificial uterus prolapse 2008-9-21

  • 来源:cfl
  • 作者:cfl
  • 更新日期:2019-07-19 21:26
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我院收治了王雪和王悦两名12,13岁的小姑娘,他们都是先天无阴道而有子宫的的患者,前者伴有宫颈管闭锁,后者宫颈基本缺如。但是我们通过特殊的建设性手术宫腹腔镜联合下人工子宫脱垂阴道成型,保全了子宫及其功能,阴道成型也很完美。 Our hospital admitte

我院收治了王雪和王悦两名12,13岁的小姑娘,他们都是先天无阴道而有子宫的的患者,前者伴有宫颈管闭锁,后者宫颈基本缺如。但是我们通过特殊的建设性手术——宫腹腔镜联合下人工子宫脱垂阴道成型,保全了子宫及其功能,阴道成型也很完美。

Our hospital admitted Wangxue and Wang Yue two 12, 13 years old girls, they are born without vagina and have uterus patients, the former with cervical canal atresia, the latter cervical basic lack. But we have a special constructive operation-the combination of laparoscopy and artificial uterus prolapse vaginal formation, preserved the uterus and its functions, vaginal formation is also perfect.

诊断:青春期后无月经来潮,有周期性下腹痛,处女膜无膨出;外阴发育正常,阴道完全闭锁;B 超发现正常偏大子宫,内有积血;激素染色体正常。

Diagnosis: No menstrual cramps after puberty, periodic abdominal pain, hymen without bulging; The vulva develops normally, the vagina atresia completely; B Super found a normal large uterus with accumulated blood; The hormone chromosome is normal.

阴道闭锁的安太疗法:宫腹腔镜联合下人工子宫脱垂阴道成型术 腹腔镜监护下沿处女膜缘打入人工隧道,直达宫颈处,探针于宫颈中心部位加压进入(有落空感)随即有暗红色血流出,探宫腔长度,4-8号扩宫器依次扩张宫颈,经宫颈管向宫腔内置入双腔造影管,置入水囊7ml,宫腔内注入美兰液,腹腔镜下见输卵管伞端美兰液流出、。将宫颈下拉与处女膜缘的阴道粘膜环形缝合一周,形成子宫脱垂状。

Antai therapy for vaginal atresia: laparoscopic laparoscopy combined with artificial uterine prolapse vaginal molding under laparoscopic monitoring enters an artificial tunnel along the edge of the hymen, directly to the cervix, and the probe enters the central part of the cervix under pressure(there is a feeling of frustration) followed by dark red blood outflow, probe cavity length, The 4-8 dilator expands the cervix in turn, enters the double-cavity angiogram tube into the uterine cavity through the cervical tube, and is inserted into the water capsule 7ml. The uterine cavity is injected with Meilan liquid. Under the laparoscope, the fallopian tube ends and the Meilan liquid flows out.The cervix is pulled down and the vaginal mucosa of the hymen margin is closed in a circular suture for one week to form a uterine prolapse.

术后月经畅通,痛经消逝,阴道随着子宫的复位逐渐上提,阴道粘膜逐渐被拉长,阴道逐渐加深。子宫完全复位之时,就是阴道成型之日。这一过程自然完成要经过3-5年,如果有性生活就会大大加速。

After the operation, menstrual flow, dysmenorrhea disappeared, the vagina gradually increased with the reduction of the uterus, the vaginal mucosa was gradually elongated, the vagina gradually deepened. When the uterus is completely reset, it is the day when the vagina is formed. This process takes three to five years to complete naturally, and if there is sex, it will greatly accelerate.

讨论:单纯阴道闭锁畸形及其罕见,有子宫而无阴道罕见的畸形,由于经血不能排除而通过输卵管反流入盆腔,每月周而复始,如不及时引流往往会形成严重的盆腔子宫内膜异位症或子宫腺肌症。要与先天无子宫无阴道的“双无”和处女膜闭锁相鉴别,治疗原则是阴道成型和引流经血。但是绝不允许切除子宫(阴道有病,子宫尚好),子宫切除就把阴道闭锁,变成了“双无”患者,使畸形进一步加深,相当于“患者左眼瞎,去治疗医生把右眼也给 捅 瞎 了。

Discussion: pure vagina atresia malformation and its rare, there is uterus but not vagina rare malformation, because menstrual blood can not rule out and through the fallopian tube back and forth into the pelvic cavity, monthly cycle, if not timely drainage will often form serious pelvic endometriosis or adenomyosis. To identify the "double absence" and hymen atresia with no uterus and no vagina, the treatment principle is vaginal formation and drainage of menstrual blood. However, the uterus must not be removed(the vagina is sick and the uterus is good). The hysterectomy turns the vagina into a "double zero" patient, further deepening the deformity, which is equivalent to "the patient's left eye is blind. Go to therapy. The doctor blinded his right eye, too.

医生见到这样的患者,如果不具备阴道成型的技术和能力,可以先行经血引流(B超引导下把铁管打入宫腔,再放上引流管,长期保留,和膀胱造漏和之长造漏一样),起到阻止痛经和导流月经作用,这符合“急则治其标”的原则。如果连造漏的技术也不具备,就应该让患者转院,这正是:留得青山在,自有后来人”。切除子宫是万万不可取的。

When the doctor sees such a patient, if he does not have the technology and ability to form a vagina, he can first drain blood(under the guidance of B ultrasound, the iron tube is inserted into the uterine cavity, and the drainage tube is put again, which is retained for a long time, and the bladder leaks and the length of the leak. The same), Play a role in preventing menstrual cramps and menstruating menstruation, which is in line with the principle of "urgent treatment of its target". If even the leak technology is not available, the patient should be transferred to hospital. This is exactly: Stay in Castle Peak and have their own future. " A hysterectomy is absolutely impossible.

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