人工阴道成形术中生物补片代阴道与腹腔镜下腹膜代阴道的比较

目的:比较人工阴道成形术中采用组织工程生物补片代阴道与腹腔镜下盆腔腹膜代阴道的临床效果。方法:选取2008年1月至2013年4月在我院行人工阴道成形术的MRKH患者67例,其中32例行猪小肠黏膜下层生物补片代阴道成形术(生物补片组),35例行腹腔镜下盆腔腹膜代阴道成形术(腹膜组)。比较两组患者的手术时间、术中出血量、术后肠功能恢复时间、住院时间、术后病率和手术费用。随访患者的术后恢复工作时间,术后阴道长度、宽度,患者及性伴侣的性生活满意度评分。结果:生物补片组患者的手术时间、出血量、术后肠功能恢复时间均显著低于腹膜组(P0.05),住院费用显著高于腹膜组;而两组的住院天数无显著差异(P0.05)。两组患者的术后病率分别为23.8%和24.5%,无显著差异(P0.05)。两组患者的人工阴道长度、宽度,患者及性伴侣对性生活的满意度评分均无显著差异(P0.05)。结论:生物补片代阴道成形术与腹腔镜下腹膜代阴道成形术均为有效的人工阴道成形术,均可满足性生活需要。生物补片代阴道成形术的方法更简便、手术损伤更小、恢复更快,但费用较昂贵。

A comparative study of laparoscopic Davydov and tissue-engineered biological material for vaginoplasty

Objective：To compare the clinical effect of laparoscopic Davydov and using tissue-engineered biological material （small intestinal submucosa,SIS） in vaginoplasty. Meth-ods：From Jan. 2008 to Apr. 2013,67 patients with Mayer-Rokitansky-Kuster-Hauser syndrome were admitted in our hospital. 32 patients underwent vaginoplasty using SIS,35 patients under-went vaginoplasty with laparoscopic pelvic peritoneum auto-transformation （ laparoscopic Davydov） . We compared the datum of operation time,blood loss,and recovery time of the intes-tinal function,date of hospitalization,morbidity after operation and expenditure of operation be-tween two groups. We followed up the time back to work,the length and width of the vagina and their quality of sexual function. Result：The mean operation time,intraoperation blood loss and time of postoperative intestinal function recovery in group SIS were less than laparoscopic Davydov（P〈0. 05）,while the cost of operation in group SIS was higher than laparoscopic Davydov. The date of hospitalization and postoperative morbidity（23. 8% vs 24. 5%） showed no significantly different between two groups. There was no statistical significance in the differ-ence of the length and width of the neovagina,sexual satisfaction between two groups. Conclu-sion：Both laparoscopic Davydov and using SIS for vaginoplasty are effective for sexual function. Using SIS for vaginoplasty is simpler,less injury and faster recovery while the expense is more.