先天性子宫颈闭锁的解剖与病理学特征研究

    Study on characteristics of anatomy and pathology of congenital cervical atresia

    • 摘要: 目的:研究先天性子宫颈闭锁的解剖及病理学特征等,探索先天性子宫颈闭锁畸形矫治方案和阴道及子宫颈成形术式的科学性。方法:对Ⅰ型1例、Ⅱ型4例、Ⅲ型2例、Ⅳ型1例的子宫切除标本和Ⅰ型5例子宫体下连积血囊腔壁活切标本进行病理学检查。追踪观察保留子宫而接受了阴道及子宫颈成形术患者的预后。结果:Ⅰ型子宫颈闭锁18例行阴道及子宫颈成形术后半年内无一例痛经,合并阴道完全闭锁者远期随访13例,2例3例次自然妊娠至足月行子宫下段剖宫产获2男婴1女婴;Ⅱ型1例行腹会阴联合阴道及子宫颈成形术,术后性生活满意,未孕,仍痛经;Ⅳ型2例行阴道及子宫颈成形术,术时子宫颈管腔置管,术后无痛经。结论:先天性子宫颈闭锁分型诊断标准对先天性子宫颈闭锁的诊治具有重要的临床价值。

       

      Abstract: Objective:To study the characteristics of anatomy and pathology of congenital cervical atresia and investigate the appropriateness of cervicovaginal plasty.Methods:The pathological examination was performed on hysterectomy specimens from 1 case of type Ⅰ,4 cases of type Ⅱ,2 cases of type Ⅲ and 1 case of type Ⅳ,and on biopsy tissue specimens of hematocele cyst cavity that connected under uterine body from 5 cases of type Ⅰ.The prognosis of patients with uterus preserved was followed up.Results:After 18 cases of patients with Type Ⅰ cervix atresia who were performed with cervicovaginal plasty,none of case was suffered from dysmenorrhea within half a year.Long-term follow-up on 13 cases of patients complicated with complete vaginal atresia,3 case-times of 2 persons have been performed lower uterine segmental cesarean section under natural pregnancy till full term,resulting 2 male babies and 1 female baby had been born successfully.One case of type Ⅱ patient who was performed with cervicovaginal plasty with combination of abdomen and cervix still suffered from dysmenorrheal and was no pregnancy.Two cases of type Ⅳ patient were performed cervicovaginal plasty with combine of abdomen and cervix with catheters indwelling in cervix duct cavities when surgery,dysmenorrhea was not happened.Conclusions:The diagnostic criterion for categorization of congenital cervical atresia is of significant clinical value for its diagnosis and treatment.

       

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