摘要
目的 探讨雄激素不敏感综合征 (androgeninsensitiviesyndrome,AIS)患者手术时间、手术方式的选择、发生腹股沟疝的可能以及处理方法。方法 选择 1983年 11月至 2 0 0 0年 7月确诊为雄激素不敏感综合征的患者共 30例。对其就诊原因和性腺位于腹股沟的发生率以及误诊的可能性进行总结性分析。结果 30例患者6 0个性腺中 ,2 4个位于腹股沟者为 2 4 ,占 4 0 0 %。单纯以腹股沟包块就诊者 5例 ,占完全型 2 6 7% (4/15 ) ,占不完全型 6 7% (1/15 )。因诊断为腹股沟疝于外院手术者 3例 (10 0 % )。结论 雄激素不敏感综合征因其性腺所处位置的特殊性 ,易被诊断为腹股沟疝。提醒外科医生接诊女性疝患者时应注意有AIS存在的可能性。因其性腺所具有的功能及恶变可能 ,性腺应予切除。完全型应在青春期第二性征发育完善后切除。不完全型一经诊断即应切除 ,同时行外阴整形手术。AIS患者术后应行激素替代治疗 (ERT)。
Objective To investigate when is the right time to do operation and which is the proper style of the operation for the patients with androgen insensitive syndrome(AIS), and the possibility of the patients with AIS to develop inguinal hernia and the way to manage it.Methods There were all together 30 cases of AIS from the division of gynecological endocrinology, department of obstetrics and gynecology from November 1983 to July 2000,who were included in this study. The following data was analysed: the style of the operations performed, the symptoms that caused them to go to hospital, the incidence of the gonads located in the inguinal sulcus and the possibility of misdiagnosis.Results Among the 60 gonads of the 30 patients, 24(40 0%) were located in the inguinal sulcus. There were 5 patients who went to the hospital only because of inguinal mass, among them 4 cases (26 7% of the 15) were complete type, 1 case was incomplete type (6 7% of the 15). There were 3 patients who had undergone operations for inguinal hernia in other hospitals.Conclusion Because of the special locations of the gonads in the AIS patients, they are prone to be diagnosed as inguinal hernia. So doctors should always keep in mind the possibility of AIS when facing female inguinal hernia. Because of the possibility of carcinogenesis with the ectopic gonads in AIS patients, gonads should be removed. On the other hand, the gonads have some kinds of function in puberty development, so gonads should be removed after the completion of the puberty development in patients with complete type AIS. While in patients with incomplete type AIS, gonads should be removed immediately after the diagnosis has been made together with the plastic surgery of the vulva. Patients of AIS should receive estrogen replacement treatment after the operation.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2002年第7期409-411,共3页
Chinese Journal of Practical Gynecology and Obstetrics
