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目的:探讨阴道斜隔综合征的病理解剖特点、临床表现、诊断及治疗。方法:回顾分析2009年1月至2014年12月我院收治的31例阴道斜隔综合征患者的临床资料,其中Ⅰ型15例,Ⅱ型15例,Ⅲ型1例,包括临床表现、辅助检查、治疗方法及预后,术后随访1年~6年。结果:Ⅰ型患者就诊年龄为(13.07±1.58)岁,86.7%于初潮半年内就诊,均以痛经为首诊就诊原因;Ⅱ、Ⅲ型患者平均就诊年龄(25.20±7.09)岁,54.5%在性生活后半年内发病,62.5%以阴道流血流液流脓为首诊就诊原因。所有患者均有阴道壁囊肿,Ⅰ型直径大于Ⅱ、Ⅲ型患者;93.5%的患者合并肾脏缺如,以右肾为主。超声诊断率93.5%,磁共振诊断率100%。31例患者均采用阴道斜隔切除术,术后阴道不规则流血流液、腹痛等症状明显缓解或消失,术后均无阴道粘连发生,有生育要求的患者中71.4%成功受孕。结论:不同分型的阴道斜隔综合征患者临床表现各异,肾脏缺如可对阴道斜隔综合征患者起到提示作用,超声及磁共振检查可以帮助明确诊断。阴道斜隔切除术是有效的治疗方法,早期的诊断及治疗可以明显缓解患者症状,预防生殖系统疾病,保护患者生育功能。
Objective: To investigate the pathological anatomy features, clinical manifestations, diagnosis and treatment of vaginal oblique syndrome. Methods: The clinical data of 31 patients with vaginal oblique syndrome admitted in our hospital from January 2009 to December 2014 were retrospectively analyzed. Among them, 15 cases were type Ⅰ, 15 cases were type Ⅱ and 1 case was type Ⅲ, including clinical manifestations, Inspection, treatment and prognosis, follow-up 1 year to 6 years. Results: The age of type Ⅰ patients was (13.07 ± 1.58) years old, 86.7% of them were referred to the first half of the menarche. All the patients were diagnosed as having dysmenorrhea. The average age of patients with type Ⅱ and Ⅲ (25.20 ± 7.09) and 54.5% Six months after the onset of life, 62.5% of vaginal bleeding fluid suppurative treatment for the first visit. All patients had vaginal wall cysts, type Ⅰ diameter greater than Ⅱ, Ⅲ type of patients; 93.5% of patients with renal absent, mainly to the right kidney. Ultrasound diagnosis rate of 93.5%, magnetic resonance diagnosis rate of 100%. All of the 31 patients underwent vaginal septum resection. The postoperative vaginal irregular blood flow, abdominal pain and other symptoms were significantly relieved or disappeared. No postoperative vaginal adhesions occurred, and 71.4% of the patients with reproductive requirements were successfully pregnant. Conclusion: The clinical manifestations of different types of patients with vaginal oblique syndrome vary, kidney deficiency may play a role in patients with vaginal oblique syndrome, ultrasound and magnetic resonance imaging can help confirm the diagnosis. Vaginal septum resection is an effective treatment, early diagnosis and treatment can significantly alleviate the symptoms of patients, prevent reproductive system diseases and protect the patient’s reproductive function.