本文選題：宮頸閉鎖　切入點：陰道閉鎖　出處：《安徽醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:評價部分小陰唇皮瓣和陰股局部皮瓣網(wǎng)狀移植人工陰道及宮頸成形術(shù)后遠期效果。方法:回顧性分析1984年3月至2015年8月期間,在阜陽市人民醫(yī)院就診的先天性宮頸閉鎖合并陰道完全閉鎖患者的臨床資料。以施行部分小陰唇皮瓣以及陰股局部皮瓣網(wǎng)狀移植人工陰道及宮頸成形術(shù)的先天性宮頸閉鎖合并陰道完全閉鎖患者為研究對象,分析兩種術(shù)式的手術(shù)情況,隨訪患者術(shù)后至今的人工陰道及宮頸的解剖情況、并發(fā)癥及生育情況,同時選用FSFI量表和SF-36健康調(diào)查表,通過電話隨訪評價患者術(shù)后性功能狀態(tài)、生活質(zhì)量。同時隨機選擇年齡匹配的健康有性生活的婦女作為對照組研究對象。結(jié)果:1.先天性宮頸閉鎖合并陰道完全閉鎖患者共20例,11例患者同意施行部分小陰唇皮瓣網(wǎng)狀移植人工陰道及宮頸成形術(shù)(A組),9例患者接受陰股局部皮瓣網(wǎng)狀移植人工陰道及宮頸成形術(shù)(B組)。2.術(shù)后隨訪結(jié)果:(1)解剖:A組患者人工陰道長8cm-11cm,平均9.20cm±1.21cm,寬約3cm;B組患者人工陰道長約8cm-10cm,平均9.12cm±1.60cm,寬約3cm。(2)性功能:A組、B組和對照組在FSFI總分以及性興趣、性喚起、陰道潤滑、性高潮、性滿意度、性交痛6個方面,三者之間相互比較,P值均大于0.05,差異無統(tǒng)計學(xué)意義。(3)生活質(zhì)量:A組、B組以及對照組在心理健康這個維度上有顯著性差異,其中A組和對照組,B組和對照組之間相比較有顯著性差異,而A組和B組之間P0.05,無顯著性差異。而在sf-36其他七個維度方面,三組之間無顯著性差異。4.5例患者自然受孕成功,均在孕37周前后行剖宮產(chǎn),子女體健,尚未發(fā)現(xiàn)畸形者。1例患者在孕3個月先后經(jīng)歷2次自然流產(chǎn)。剩余部分患者因未到生育階段故需繼續(xù)隨訪。結(jié)論:部分小陰唇皮瓣和陰股局部皮瓣網(wǎng)狀移植人工陰道及宮頸成形術(shù)操作簡單、手術(shù)損傷小,并發(fā)癥少,且能達到解剖學(xué)成功與正常女性的性功能狀態(tài)。并且,兩種手術(shù)對患者生活質(zhì)量影響不大,但手術(shù)是否影響精神健康需進一步研究。因手術(shù)例數(shù)有限,有待于更大樣本的支持。
[Abstract]:Objective: to evaluate the long-term effects of partial labial labia flap and local clavicular flap on artificial vagina and cervicoplasty. Methods: the period from March 1984 to August 2015 was retrospectively analyzed. Clinical data of patients with congenital cervix atresia combined with complete vaginal atresia in Fuyang people's Hospital. Cervical atresia with complete vaginal atresia was studied. The anatomic status, complications and fertility of the artificial vagina and cervix were analyzed. FSFI scale and SF-36 health questionnaire were used to evaluate the sexual function of the patients by telephone follow-up. Quality of life. At the same time, healthy and sexually active women matched with age were randomly selected as control group. Results 1. 20 patients with congenital cervix atresia and complete vaginal atresia were selected as control group. A total of 11 patients with congenital cervix atresia and complete vaginal atresia agreed to take part of small yin. Labial flap mesh graft artificial vagina and cervicoplasty group A (n = 9) received vaginal graft with vaginal local flap and cervicoplasty group B (n = 2). Follow-up results showed that the length of artificial vagina in group A was 8 cm ~ 11 cm (mean 9.20 cm 鹵1.21 cm), and that in group A was 8 cm ~ 11 cm (mean, 9.20 cm 鹵1.21 cm). The length of artificial vagina in group B was about 8 cm to 10 cm (mean 9.12 cm 鹵1.60 cm, width about 3 cm. 2) the total score of FSFI and sexual interest in group B and control group were 3 cm to 10 cm, respectively. Sexual arousal, vaginal lubrication, orgasm, sexual satisfaction, intercourse pain, There were significant differences in the dimension of mental health between group A and group B and control group. There was significant difference between group A and control group B and control group, but there was no significant difference between group A and group B. in the other seven dimensions of sf-36, there was no significant difference among the three groups. All of them underwent cesarean section before and after 37 weeks of gestation, and their children were in good health. In the third month of pregnancy, 1 cases of deformities had experienced 2 spontaneous abortions. The rest of the patients needed to be followed up because they had not reached the reproductive stage. Conclusion: partial labial labia flap and local skin flap of vulva and femoris are artificial grafts. Vaginal and cervical angioplasty is simple, The surgical injury is small, the complication is few, and can achieve the anatomical success and the normal female sexual function state. Moreover, the two kinds of surgery have little influence on the patient's quality of life, but whether the operation affects the mental health needs further study. Support is expected from a larger sample.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R713

【相似文獻】

相關(guān)期刊論文 前10條

1 王雪純;乙狀結(jié)腸人工陰道33例臨床分析[J];徐州醫(yī)學(xué)院學(xué)報;1997年06期

2 王淑寶;范麗華;;人工陰道，讓“石女”重塑女兒身[J];人生與伴侶(月末版);2007年09期

3 胡泳，陳忠東，，曾憲端;乙狀結(jié)腸代人工陰道手術(shù)成功10例報告[J];衡陽醫(yī)學(xué)院學(xué)報;1995年04期

4 晉茂生,黃明枝;胎兒皮移植人工陰道23例分析[J];安徽醫(yī)學(xué);1996年05期

5 張友紅;;乙狀結(jié)腸代人工陰道手術(shù)前后的護理[J];中國實用護理雜志;1992年02期

6 陳興無;譚孝期;夏姿芳;賓偉;;乙狀結(jié)腸代人工陰道8例臨床體會[J];醫(yī)學(xué)理論與實踐;2008年06期

7 何懷;CO_2激光治療人工陰道巨大尖銳濕疣1例[J];中國激光醫(yī)學(xué)雜志;2003年03期

8 劉冬芝;人工陰道用于實驗雄兔采精的體會[J];上海實驗動物科學(xué);1994年02期

9 葉秀霞,陳公高;乙狀結(jié)腸代人工陰道新術(shù)式治療先天性無陰道12例[J];溫州醫(yī)學(xué)院學(xué)報;1986年01期

10 朱天琪，尤金鐘，張中蘇;黃蜈宮糜泰中微量有毒元素的分析[J];中國中藥雜志;1995年05期

相關(guān)會議論文 前1條

1 潘麗萍;;一例乙狀結(jié)腸人工陰道成行術(shù)的護理[A];全國婦產(chǎn)科護理學(xué)術(shù)交流暨專題講座會議論文匯編[C];2003年

相關(guān)碩士學(xué)位論文 前3條

1 袁梅;部分小陰唇皮瓣和陰股局部皮瓣網(wǎng)狀移植人工陰道及宮頸成形術(shù)治療先天性宮頸閉鎖合并陰道完全閉鎖的遠期效果評價[D];安徽醫(yī)科大學(xué);2016年

2 張琳;乙狀結(jié)腸代陰道成形術(shù)后人工陰道局部防御功能變化的研究[D];河北醫(yī)科大學(xué);2008年

3 崔麗麗;乙狀結(jié)腸代陰道成形術(shù)后人工陰道分泌功能的變化及術(shù)后生活質(zhì)量的評估[D];河北醫(yī)科大學(xué);2014年

本文編號：1558920