11岁女孩急性尿潴留掩盖下的处女膜闭锁： 临床病例

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处女膜闭锁是一种罕见的女性生殖器官先天畸形，通常在青春期女孩初潮后被诊断。在部分情况下，由于症状缺乏特异性，可能模拟其他系统疾病，增加诊断难度。本文报道一例11岁女童的临床病例，患者在一周内出现排尿时疼痛。最后24小时完全无法自主排尿。由急救团队送至莫斯科N.F. Filatov Children’s City Clinical Hospital。初步检查未发现明显泌尿系统病因，因此进行了扩展检查。结合病史（未见初潮）、妇科查体及超声检查，发现阴道扩张并充满经血（血阴道积聚，hematocolpos）， 为机械性压迫尿道并导致急性尿潴留的主要原因。该病理的基础是先天性处女膜闭锁。患者行导尿术，排出尿液750 ml。次日在全身麻醉下实施处女膜十字形切开术，排出血性内容物300 ml，并行阴道冲洗。留置Foley导尿管，第3天拔除。术后给予短程抗生素治疗，排尿恢复。第5天康复出院，转入儿科妇科随访。该病例提示，应提高外科医生对青春期前后女童急性尿潴留和周期性下腹痛中处女膜闭锁可能性的认识。在本病例中，妇科查体与盆腔超声确诊了血阴道积聚， 并使患者得以及时接受手术治疗。

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作者简介

Madina A. Chundokova

N.F. Filatov Children’s City Hospital; Pirogov Russian National Research Medical University

Email: cmadina@yandex.ru
ORCID iD: 0000-0002-5080-4838
SPIN 代码: 1122-0394

MD, Dr. Sci. (Medicine), Assistant Professor

俄罗斯联邦, Moscow; Moscow

Yulia V. Petrukhina

N.F. Filatov Children’s City Hospital; Pirogov Russian National Research Medical University; Research Institute for Healthcare Organization and Medical Management

编辑信件的主要联系方式.
Email: petrukhina-j@mail.ru
ORCID iD: 0000-0002-7991-3632
SPIN 代码: 7949-0670

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Moscow; Moscow; Moscow

Andrei I. Zakharov

N.F. Filatov Children’s City Hospital

Email: zaharov@pedurology.ru
ORCID iD: 0000-0002-8415-4968
SPIN 代码: 8774-5827

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Moscow

Nadezhda S. Bakaeva

Pirogov Russian National Research Medical University

Email: bakaeva.2000@bk.ru
ORCID iD: 0000-0001-9897-2649
SPIN 代码: 7221-8025
俄罗斯联邦, Moscow

Sophia A. Garnovskaya

Pirogov Russian National Research Medical University

Email: sophia.garnovskaya@mail.ru
ORCID iD: 0009-0004-8539-1107
SPIN 代码: 8039-1636
俄罗斯联邦, Moscow

参考

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2. Fig 1. External view of the perineum: the arrow indicates an imperforate hymen.

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3. Fig. 2. Ultrasound of the uterus. 1, uterine body; 2, cervix.

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4. Fig. 3. Ultrasound of the uterus and vagina. 1, cervix; 2, vagina.

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5. Fig. 4. External view of the perineum after surgery: a, hymen after incision, vaginal patency restored; b, intraoperative verification of vaginal patency using forceps.

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