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1病例报告患者女,11岁。15天前无明显诱因出现下腹部坠胀感、尿频,起初未在意。1天前出现下腹部胀痛,小便困难,无阴道出血。在当地诊所给予导尿处理,自觉症状缓解,小便能少量自解。回家休息后,又感下腹部胀痛,遂入我院就诊。超声检查:子宫4.7cm×3.2cm×5.0cm,形态尚规则。宫腔扩张,宫腔内可见前后径1.1~1.8cm无回声区;宫体下段至阴道扩张,以阴道较明显,可见10.4cm×6.6cm无回声区,其内有密集暗淡回声光点漂浮;与宫腔内无回声区相通(图1)。子宫后方可见前后径约0.4cm无回声区。超声诊断:宫腔积液;处女膜闭锁。局麻下行处女膜切开造口术。取膀胱截石位,常规消毒外阴,见处女膜无孔,且膨出呈紫蓝色,注射器抽吸出暗黑色经血。给予利多卡因局部麻醉,于阴道口闭锁处女膜突出部做“X”形切开至处女膜环根部,见潴留的暗黑色黏稠经血流出,量约200ml。
1 case report Patients female, 11 years old. 15 days ago no obvious incentive to lower abdominal bulge, frequent urination, at first did not care. A lower abdominal pain occurred 1 day ago, urination difficulties, no vaginal bleeding. In the local clinic to give catheterization treatment, relieve symptoms, urine can be a small amount of self-solution. After returning home, but also feel abdominal pain, then into our hospital. Ultrasonography: the uterus 4.7cm × 3.2cm × 5.0cm, the shape is still rules. Uterine dilatation, uterine cavity before and after the visible 1.1 ~ 1.8cm anechoic area; lower uterine segment to vaginal dilation to the vagina is more obvious, showing 10.4cm × 6.6cm anechoic zone, which has a dense dark echo echo light floating ; And intrauterine anechoic zone interlinked (Figure 1). The anteroposterior diameter of about 0.4cm after the uterus can be seen without echo area. Ultrasound diagnosis: uterine fluid; hymen atresia. Local anesthesia downstream hymen cut open stoma. Take bladder lithotomy position, conventional disinfection of the vulva, see the hymen non-porous, and the swelling was purple-blue, syringe suction dark blood. Give lidocaine local anesthesia, at the vaginal orifice blocking hymen protrusion to do “X ” shape cut to the hymen ring root, see retention of dark black viscous menstrual flow, the amount of about 200ml.