摘要目的 介绍小阴唇增生的分型方法,并探讨其对各类手术方式选择的指导意义.方法 2014年8月至2018年4月,中国医学科学院整形外科医院妇科整形中心共收治先天性小阴唇增生患者1 058例,年龄18～46岁,平均25岁.根据小阴唇及阴蒂包皮组织增生的程度,将小阴唇增生分为单纯小阴唇增生型、单纯阴蒂包皮增生型以及复合增生型3类.对于单纯小阴唇增生型,根据小阴唇组织增生程度,应用边缘切除法,或者楔形切除法,或者二者结合的方法.单纯阴蒂包皮增生型患者中,可以单纯将多余阴蒂包皮切除.对于复合增生型患者,根据小阴唇和阴蒂包皮增生的程度及两者的关系,分别选择适合的术式.结果 1 058例中单纯小阴唇增生患者83例(7.8％),单纯阴蒂包皮增生患者25例(2.4％),复合增生型950例(89.8％).所有患者根据新的分型方法分类后,均有针对性地选择了各自适宜的方法.其中1 033例患者接受了手术治疗,术后切口均一期愈合,外形改善明显.于术后1、3、6个月返院复查,阴蒂包皮术后复发19例,感觉双侧明显不对称28例,术后仍感觉小阴唇过大者6例,小阴唇水肿增生肥厚者5例,其余980例均对术后效果感到满意.结论 小阴唇与阴蒂包皮是同源组织,在进行小阴唇整形时必须具有整体观念.根据小阴唇增生的3大分型方法,可以选择合适的手术方法,获得满意的手术效果.

abstractsObjective To introduce a method to classify the labia minora hypertrophy and to investigate its significance to the selection of surgical method.Methods From August 2014 to April 2018,1 058 patients with labia minora hypertrophy were treated in the Plastic Surgery Hospital.According to the hyperplastic degree of the labia minora and praeputium clitoridis,the labia minora hypertrophy was classified to three types,namely simple clitoridis hypertrophy,simple labia minora hypertrophy and mixed type.For patients with simple labia minora hypertrophy,the methods of margin resection,or wedge resection or combination were applied.For patients with simple clitoridis hypertrophy,the reduction of clitoris hood could be performed.For mixed type,firstly the relationship of clitoris hood and labia minor should be recognized,then the appropriate surgical method should be taken.Results The age of the patients was 18 to 46 years (mean age was 25 years).83 cases (7.8％) were simple labia minora hypertrophy.25 cases (2.4％)were simple clitoridis hypertrophy.And 950 cases (89.8％) were mixed type.All the patients received appropriate surgical method to repair the malformation.All the surgeries were successfully performed and the cosmetic results were satisfying.Conclusions As the homologous tissues,whether praeputium clitoridis hypertrophy or labia minora hypertrophy could result poor appearance of female vulva.The concept of holism should be kept in mind when repair surgeries are performed.The labia minora hypertrophy was classified to three types and appreciate surgical methods were applied to repair the hypertrophy.The cosmetic result was satisfying.