【摘要】：目的總結(jié)兒童卵睪型性發(fā)育異常的診斷、性別選擇及臨床治療。方法回顧性分析2004—2014年在鄭州大學(xué)第一附屬醫(yī)院手術(shù)治療的10例卵睪型性發(fā)育異�；純旱呐R床資料。社會性別:男4例,女6例,首次就診年齡11個月~14歲,10例患兒均接受合理的性別選擇、外科手術(shù)及內(nèi)分泌藥物治療,隨訪其近期和遠期治療效果。結(jié)果10例患者中1例男性矯治為女性,余9例性別未轉(zhuǎn)變。按女性撫養(yǎng)者,行睪丸或卵睪組織切除和陰蒂會陰成形術(shù),青春期后行陰道成形術(shù)。按男性撫養(yǎng)者,行睪丸固定,卵巢或卵睪及子宮附件切除,同期行尿道下裂成形修復(fù)。10例隨訪2~12年,家屬及大年齡患兒均對性別選取滿意,4例患兒進入青春期,其中2例女性第二性征發(fā)育中等或良好,2例男性陰莖及睪丸發(fā)育略差或中等,均有晨勃現(xiàn)象,性功能及生育能力需繼續(xù)觀察。結(jié)論兒童卵睪型性發(fā)育異常需早期正確診斷,根據(jù)患兒的外生殖器、優(yōu)勢性腺、社會性別、結(jié)合患兒及家屬意愿早期合理地選擇性別并采取正確手術(shù)矯正,必要時輔以激素替代治療及心理治療,效果滿意。
[Abstract]:Objective to summarize the diagnosis, sex selection and clinical treatment of otorchidism in children. Methods the clinical data of 10 children with otorchidism dysplasia treated in the first affiliated Hospital of Zhengzhou University from 2004 to 2014 were retrospectively analyzed. Gender: male 4 cases, female 6 cases, the first visit age of 11 months to 14 years old 10 cases of children with a reasonable gender selection, surgery and endocrine drug treatment, follow up their short-term and long-term treatment results. Results among the 10 patients, one male was treated as female, and the other 9 were not changed in sex. For female dependents, testiculectomy and clitoral perineoplasty were performed, and vaginoplasty was performed after puberty. Male dependents were treated with testicular fixation, ovary or egg testis and uterus adnexa resection, and hypospadias repair with hypospadias for 2 to 12 years. Family members and older children were satisfied with sex selection and 4 children reached puberty. Among them, 2 cases of female secondary sexual development were moderate or good, and 2 cases of male penis and testis developed slightly or moderately, all of them had the phenomenon of morning bob. The sexual function and fertility should be observed continuously. Conclusion early diagnosis is necessary for children with otorchidism dysplasia. According to the external genitalia, dominant gonads, social sex and the wishes of the children and their families, the children and their families should be able to select and correct the sex at an early stage and adopt the correct surgical correction. Hormone replacement therapy and psychotherapy were used when necessary, and the results were satisfactory.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院小兒外科;
【分類號】：R726.9

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