珍屯医学

标题: 阴道狭窄 [打印本页]

作者: 大江 时间: 2020-3-14 00:01
标题: 阴道狭窄
阴道狭窄是一种异常情况，由于纤维组织的形成，阴道变得越来越狭窄。[1] [2]阴道狭窄会对性功能障碍，性生活困难造成负面影响，并使盆腔检查困难而痛苦。[1]阴道内壁也可能更薄更干燥，并且包含疤痕组织。这种情况可能导致性生活或骨盆检查时的疼痛。阴道狭窄通常是由会阴切开术，骨盆放疗或某些类型的手术引起的。[3] [4] [5]化学疗法还可以增加发生阴道狭窄的可能性。[6]阴道狭窄可能是先天性肾上腺增生引起的缺陷。[7]会阴切开术与狭窄相关。[8]

内容
1 原因
1.1 辐射诱发
1.2 先天性
2 治疗
3 参考

原因
辐射诱发
子宫癌，阴道癌，直肠癌和宫颈癌通常用骨盆放射疗法（RT）进行治疗。辐射诱发的阴道狭窄可能是治疗的副作用。[9] [10]原因是外部束放射疗法（EBRT）或近距离放射疗法。[1] [10]这是骨盆辐射最普遍的副作用之一，约有三分之一的女性受到影响。[11] [12]辐射诱发的狭窄可能是治疗的晚期反应。阴道上皮受损会导致胶原蛋白异常产生，从而导致萎缩，肌肉丢失，血流减少，缺氧和纤维化。可以观察到苍白，粘连和脆性以及弹性损失。[1]

先天性的
产前肾上腺雄激素抑制不足会导致先天性肾上腺增生。这种情况可能导致阴道受到狭窄的影响。[7]

治疗
阴道狭窄可用阴道扩张器治疗，但缺乏证据表明其功效。[13] [14]

参考文献：
Morris L, Do V, Chard J, Brand AH (2 May 2017). "Radiation-induced vaginal stenosis: current perspectives". International Journal of Women's Health. 9: 273–279. doi:10.2147/IJWH.S106796. PMC 5422455. PMID 28496367.
"Vaginal stenosis". TheFreeDictionary. Retrieved 2018-03-11.
"Vaginal Outlet Stenosis Repair". www.寰椎ofpelvicsurgery. Retrieved 2018-03-11.
"NCI Dictionary of Cancer Terms -Vaginal Stenosis". National Cancer Institute. Retrieved 2018-03-14. This article incorporates text from this source, which is in the public domain.
Rosa, Luciana Martins da; Hammerschmidt, Karina Silveira de Almeida; Radünz, Vera; Ilha, Patrícia; Tomasi, Andrelise Viana Rosa; Valcarenghi, Rafaela Vivian; Rosa, Luciana Martins da; Hammerschmidt, Karina Silveira de Almeida; Radünz, Vera (2016). "EVALUATION AND CLASSIFICATION OF VAGINAL STENOSIS AFTER BRACHYTHERAPY". Texto & Contexto - Enfermagem. 25 (2). doi:10.1590/0104-07072016003010014. ISSN 0104-0707.
http://www.uhn.ca/病人Families ... aginal_Stenosis.pdf
Merke DP, Poppas DP (December 2013). "Management of adolescents with congenital adrenal hyperplasia". The Lancet. Diabetes & Endocrinology. 1 (4): 341–52. doi:10.1016/S2213-8587(13)70138-4. PMC 4163910. PMID 24622419.
Venes, Donald (2017-01-25). Taber's Cyclopedic Medical Dictionary - Episiotomy. F.A. Davis. ISBN 9780803659407.
Harkenrider MM, Block AM, Alektiar KM, Gaffney DK, Jones E, Klopp A, Viswanathan AN, Small W (2017). "American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review". Brachytherapy. 16 (1): 95–108. doi:10.1016/j.brachy.2016.04.005. PMC 5612425. PMID 27260082.
Morris L, Do V, Chard J, Brand AH (2017-05-02). "Radiation-induced vaginal stenosis: current perspectives". International Journal of Women's Health. 9: 273–279. doi:10.2147/IJWH.S106796. PMC 5422455. PMID 28496367.
"Pelvic Physiotherapy in the Prevention of Vaginal Stenosis Secondary to the Radiotherapy; ClinicalTrials.gov". Retrieved 2018-03-11. This article incorporates text from this source, which is in the public domain.
"Management of radiation induced vaginal stenosis eviQ; (Australian, evidence-based health information)". www.eviq.org.au. Retrieved 2018-03-11.
Miles, Tracie; Johnson, Nick (2014-09-08). Cochrane Gynaecological, Neuro-oncology and Orphan Cancer Group (ed.). "Vaginal dilator therapy for women receiving pelvic radiotherapy". Cochrane Database of Systematic Reviews (9): CD007291. doi:10.1002/14651858.CD007291.pub3. PMC 6513398. PMID 25198150.
White ID, Faithfull S (May 2006). "Vaginal dilation associated with pelvic radiotherapy: a UK survey of current practice". International Journal of Gynecological Cancer. 16 (3): 1140–6. doi:10.1111/j.1525-1438.2006.00452.x. PMID 16803497.

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