儿童卵睾型性发育异常10例临床治疗经验总结

发布时间：2018-08-30 13:29

【摘要】：目的总结儿童卵睾型性发育异常的诊断、性别选择及临床治疗。方法回顾性分析2004—2014年在郑州大学第一附属医院手术治疗的10例卵睾型性发育异常患儿的临床资料。社会性别:男4例,女6例,首次就诊年龄11个月~14岁,10例患儿均接受合理的性别选择、外科手术及内分泌药物治疗,随访其近期和远期治疗效果。结果10例患者中1例男性矫治为女性,余9例性别未转变。按女性抚养者,行睾丸或卵睾组织切除和阴蒂会阴成形术,青春期后行阴道成形术。按男性抚养者,行睾丸固定,卵巢或卵睾及子宫附件切除,同期行尿道下裂成形修复。10例随访2~12年,家属及大年龄患儿均对性别选取满意,4例患儿进入青春期,其中2例女性第二性征发育中等或良好,2例男性阴茎及睾丸发育略差或中等,均有晨勃现象,性功能及生育能力需继续观察。结论儿童卵睾型性发育异常需早期正确诊断,根据患儿的外生殖器、优势性腺、社会性别、结合患儿及家属意愿早期合理地选择性别并采取正确手术矫正,必要时辅以激素替代治疗及心理治疗,效果满意。
[Abstract]:Objective to summarize the diagnosis, sex selection and clinical treatment of otorchidism in children. Methods the clinical data of 10 children with otorchidism dysplasia treated in the first affiliated Hospital of Zhengzhou University from 2004 to 2014 were retrospectively analyzed. Gender: male 4 cases, female 6 cases, the first visit age of 11 months to 14 years old 10 cases of children with a reasonable gender selection, surgery and endocrine drug treatment, follow up their short-term and long-term treatment results. Results among the 10 patients, one male was treated as female, and the other 9 were not changed in sex. For female dependents, testiculectomy and clitoral perineoplasty were performed, and vaginoplasty was performed after puberty. Male dependents were treated with testicular fixation, ovary or egg testis and uterus adnexa resection, and hypospadias repair with hypospadias for 2 to 12 years. Family members and older children were satisfied with sex selection and 4 children reached puberty. Among them, 2 cases of female secondary sexual development were moderate or good, and 2 cases of male penis and testis developed slightly or moderately, all of them had the phenomenon of morning bob. The sexual function and fertility should be observed continuously. Conclusion early diagnosis is necessary for children with otorchidism dysplasia. According to the external genitalia, dominant gonads, social sex and the wishes of the children and their families, the children and their families should be able to select and correct the sex at an early stage and adopt the correct surgical correction. Hormone replacement therapy and psychotherapy were used when necessary, and the results were satisfactory.
【作者单位】：郑州大学第一附属医院小儿外科;
【分类号】：R726.9

【相似文献】