目的 分析因妇科疾病住院治疗的儿童病例的临床特点。方法 回顾性分析妇科住院治疗的147例患儿的临床资料。结果 147例小儿妇科疾病住院病例中以卵巢肿瘤最多 (36.1%,53/147)、其次为生殖道发育异常或畸形 (19.7%,29/147)、青春期功能失调性子宫出血 (12.2%,18/147)、外伤性外阴阴道损伤 (10.2%,15/147)、阴道异物 (5.4%,8/147)。卵巢肿瘤患儿主要表现为腹痛和腹盆腔包块,生殖道畸形主要表现为进行性加重的腹痛,而青春期功血则以月经不调或不规则阴道流血或阴道大量流血为主要表现。对卵巢肿瘤、生殖道畸形或发育异常均进行了相应的手术治疗,青春期功血的治疗主要根据临床表现和子宫内膜厚度采用不同方案的性激素止血。8例阴道异物均采用宫腔镜阴道检查,在不损伤处女膜的情况下成功取出阴道异物。1例输卵管妊娠进行了腹腔镜输卵管妊娠病灶清除术,1例葡萄胎患儿清宫术后确诊为侵袭性葡萄胎行化疗。结论 小儿妇科疾病发病率居前3位的依次是卵巢肿瘤、生殖道发育异常或畸形、青春期功能失调性子宫出血;常见症状为腹痛、腹盆腔包块、阴道不规则流血;诊治过程要充分考虑到儿童的生理和生殖特点,充分发挥腹腔镜、宫腔镜、B超等诊疗器械的优势。
Abstract
Objective To study the clinical features of gynecological diseases in hospitalized children. Methods A retrospective analysis was performed for the clinical data of 147 children with gynecological diseases who were hospitalized and treated in the department of gynecology. Results Among the 147 children, ovarian tumors were most common (53 cases, 36.1%), followed by reproductive tract dysplasia or malformation (29 cases, 19.7%), adolescent dysfunctional uterine bleeding (18 cases, 12.2%), traumatic injury in the vulva/vagina (15 cases, 10.2%), and vaginal foreign body (8 cases, 5.4%). The main symptoms of ovarian tumors included abdominal pain and abdominal or pelvic mass. Progressive abdominal pain was a main symptom in children with reproductive tract dysplasia or malformation. The children with adolescent dysfunctional uterine bleeding manifested as irregular or a lot of vaginal bleeding. The children with ovarian tumors and reproductive tract malformation or dysplasia were given surgical treatment, and those with adolescent dysfunctional uterine bleeding were given different sex hormones based on their clinical manifestations and endometrial thickness. Eight children with vaginal foreign body underwent hysteroscopy for vaginal examination, and the foreign body was successfully removed without the damage of the hymen. One patient with tubal pregnancy underwent laparoscopic tubal pregnancy debridement. One patient with hydatid mole was diagnosed with invasive hydatid mole after complete curettage of uterine cavity and then received chemotherapy. Conclusions The top three gynecological diseases in children are ovarian tumors, reproductive tract dysplasia or malformation, and adolescent dysfunctional uterine bleeding. Common chief complaints of the patients include abdominal pain, abdominal masses, and irregular vaginal bleeding. Diagnosis and treatment should fully consider the physiological and reproductive features of children and give full play to the advantages of laparoscopy, hysteroscopy, and ultrasound.
关键词
妇科疾病 /
儿童
Key words
Gynecological disease /
Child
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参考文献
[1] 沈铿. 要重视小儿妇科疾病的诊断和治疗[J]. 中国实用妇科与产科杂志, 2004, 20(9):513-514.
[2] 刘菊玲, 李琳. 城乡女中学生1376例妇科疾病调查分析[J]. 吉林医学, 2011, 32(5):909-910.
[3] 季钗, 夏永辉, 潘存梅, 等. 106例小儿妇科疾病分析[J]. 浙江预防医学, 2001, 13(9):45-46.
[4] 蔡扬洋, 柴泽英, 任虹平. 84例住院小儿妇科疾病分析[J]. 现代预防医学, 2007, 34(10):1917-1918.
[5] 徐惠民, 袁捷. 青少年及小儿急腹症中妇科问题误诊情况分析[J]. 临床和实验医学杂志, 2011, 10(23):1866-1867.
[6] Samacki S, Brisse H. Surgery of ovarian tumors in children[J]. Horm Res Pediatr, 201l, 75(3):220-224.
[7] 田畦, 肖松舒, 薛敏. 成人腹腔镜器械治疗小儿卵巢良性肿瘤9例临床分析[J]. 中国内镜杂志, 2015, 21(3):322-325.
[8] 林仲秋, 林荣春, 沈青丽. 影像学检查在女性生殖道畸形诊断中的应用价值[J]. 中国实用妇科与产科杂志, 2005, 21(8):453-455.
[9] 朱可安,Jolinda Johary,徐大宝. 应用宫腔镜诊治幼女和少女妇科疾病.[J].《国际妇产科学杂志》, 2014(5):545-549.
[10] de Ravello L, Folkema A, Tulloch S, et al. Ectopic pregnancy among American Indian and Alaska native women, 2002-2009[J]. Matern Child Health J, 2015, 19(4):733-788.
[11] 王英, 平花, 余娜. 上海市松江区少女妊娠现状调查[J]. 中国生育健康杂志, 2015, 26(2):145-146.
[12] 陈少博, 关铮. 青春期妇科疾病诊治进展[J]. 国际妇产科学杂志, 2015, 42(1):9-12.
[13] 石一复. 重视小儿妇科的学科建设和发展[J]. 国际妇产科学杂志, 2015, 42(1):7-8.