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目的探讨口腔黏膜移植在阴道成形术中的应用效果。方法收集2007年3月至2009年4月北京安太医院手术的100例先天性无阴道患者。年龄18～45岁,平均27岁。第二性征发育正常,阴道前庭处未探及阴道或仅有浅凹陷,双侧卵巢正常,激素水平正常,染色体均为46,XX;腔内B超显示均为无子宫或始基子宫。术中取患者双侧颊部黏膜2.0cm×6.0cm,将皮片割成网状,蒙在棉质模具顶端,置于阴道造穴内。结果阴道成形术手术时间为1～2h,术中出血50～100mL,均无术后并发症发生。100例均获随访,随访时间6个月至3年。再造阴道深10～14cm,黏膜光滑红润,弹性好,近阴道外口处阴道壁可见皱襞,病理检查示复层鳞状上皮。外阴外观与正常女性相同。口腔内供黏膜区域不留瘢痕,术后无明显口腔功能障碍。患者均于术后1个月后开始性生活或使用电动仿真模具,均未出现疼痛、出血。结论口腔黏膜移植阴道成形术,阴道黏膜逼真,创伤小,口腔及外阴形态无破坏。
Objective To investigate the effect of oral mucosa transplantation in vaginoplasty. Methods 100 cases of congenital absence of vagina from March 2007 to April 2009 in Beijing An Tai Hospital were collected. Age 18 to 45 years old, average 27 years old. The secondary sexual characteristics of normal development, vaginal vestibule was not detected and the vagina or only shallow depression, bilateral ovarian normal, normal hormone levels, chromosomes were 46, XX; intraluminal B-ultrasound showed no uterus or primordial uterus. Intraoperative patients with both sides of the buccal mucosa 2.0cm × 6.0cm, the skin cut into mesh, the top of the cotton mold, placed in the vagina to make points. Results The time of vaginoplasty was 1 ~ 2h and the bleeding was 50 ~ 100mL. No postoperative complication occurred. 100 cases were followed up for 6 months to 3 years. Reconstruction of the vagina 10 ~ 14cm deep, smooth and rosy mucous membrane, good elasticity, vaginal wall near the vagina can be seen folds, pathological examination showed stratified squamous epithelium. The vulva looks the same as normal women. Oral mucosal area for scarring, postoperative no significant oral dysfunction. Patients were started after 1 month of life or use of electric simulation mold, were not pain, bleeding. Conclusion Oral mucosal transplantation vaginoplasty, vaginal mucosa realistic, small trauma, oral and vulva morphology without damage.