临床小儿外科杂志2025，Vol.24Issue(3)：236-242,7.DOI:10.3760/cma.j.cn101785-202308044-007
不同年龄段先天性肾上腺皮质增生合并外生殖器男性化女童术后并发症与手术效果分析
Analysis of postoperative complications and surgical outcomes of feminizing genitoplasties in girls with congenital adrenal hyperplasia and masculinized external genitalia across different age groups
摘要
Abstract
Objective To compare the postoperative complications and outcomes of feminizing genito-plasties(FG)in girls with congenital adrenal hyperplasia(CAH)and masculinized external genitalia across different age groups.Methods We conducted a retrospective analysis of 32 girls with CAH andmasculinized genitalia who underwent FG procedures at Hebei Children's Hospital from March 2010 to August 2022.Patients were divided into two groups based on age:infants and young children(≤ 3 years)and older children group(＞3 years).The infant group included 15 cases-14 underwent clitoroplasty and 1 underwent clitoroplasty plus vaginoplasty.The older group included 17 cases-16 received clitoroplasty and 1 received both clitoridoplasty and vaginoplasty.Clinical characteristics were compared between the groups,with significant differences only in sur-gical age[(1.75±0.59)years vs.(5.52±2.37)years,P＜0.001];other factors showed no statistically significant differences(P＞0.05).Outcome measures included Prader staging,type of surgical procedure,oper-ation time,follow-up duration,follow-up age,early and late postoperative complications,and caregiver satisfac-tion with postoperative genital appearance.Results Age at surgery was an independent predictor of overall genital appearance satisfaction postoperatively(OR=0.068,95％CI:0.005-0.849,P＜0.05).Among the 32 girls,7(21.88％)experienced postoperative complications:2 cases(13.33％)in the infant group had compli-cations,including incision bleeding(1 case)and early infection with later vulvar scarring(1 case).In the ol-der group,5 cases(29.41％)experienced complications:incision bleeding(3 cases)and catheter-associated urinary infection(2 cases).There were no statistically significant differences between groups in complication rate(P＞0.05).Comparative analysis of satisfaction with genital appearance showed no significant differences between the groups for symmetry[(2.40±0.51)vs.(2.24±0.56)],clitoral size[(2.47±0.52)vs.(2.12±0.70)],clitoral position[(2.33±0.49)vs.(2.18±0.73)],vaginal introitus appearance[(2.27±0.59)vs.(1.94±0.56)],labial appearance[(2.13±0.64)vs.(1.76±0.56)],and genital skin quality[(1.93±0.59)vs.(1.82±0.64)](P＞0.05).However,the total appearance satisfaction score was significantly higher in the infant group[(13.53±1.55)vs.(12.06±2.33),(P＜0.05)].Conclusions Surgery during infan-cy is associated with higher overall satisfaction in postoperative genital appearance.FG performed before age 3 yields higher appearance satisfaction scores and lower complication rates than surgeries conducted later.关键词
先天性肾上腺皮质增生症/性别发育异常/女性化外生殖器成形术/阴蒂成形术/阴道成形术Key words
Congenital Adrenal Hyperplasia/Disorders of Sex Development/Feminizing Genitoplasty/Clitoroplasty/Vaginoplasty引用本文复制引用
赵士猛,崔晓薇,曹延延,齐灿,刘丽君,陈潇潇,刘颖业,刘蕾,周云..不同年龄段先天性肾上腺皮质增生合并外生殖器男性化女童术后并发症与手术效果分析[J].临床小儿外科杂志,2025,24(3):236-242,7.基金项目
河北省重点研发计划卫生健康创新专项项目(21377710D) （21377710D）
河北省医学科学研究课题计划(20231130) Key Research and Development Plan of Hebei Province-Special Project for Health Innova-tion(21377710D) （20231130）
Medical Science Research Project Plan of Hebei Province(20231130) （20231130）
