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46XY性发育异常疾病的诊治

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[关键词] 46,XY 性发育异常疾病;诊断;治疗Diagnosis and treatment of 46, XY DSDFEI Yingchun, XU Zhe*, LIU Wenxu, XIE Jialun, LI Zuoqing(Department of Pediatric Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China)[Abstract] Objective: To summarize the clinical characteristic and rational treatment of 46,XY DSD. Methods: A retrospective analysis was performed on 26 46,XY DSD patients which were admitted in our hospital from 1979.1 to 2024.2, including sex chromosome, gonad, pudendum appearance, course of treatment, etc. Results: There were 14 cases of androgen insensitive syndrome, 5 cases of 5 -reducase abnormality, 4 cases of Muller"s αduct perpetuity syndrome, 3 cases of testosterone dyssynthesis. The social sex were determined to be male in 15 cases, female in 11 cases which were performed orchiectomy. Conclusion: The diagnosis and typing of 46, XY DSD are based on careful physical examination, aggregate analysis of phenotype, sex chromosome, gonads, etc. The social sex should be determined before 3 years old.[Key words] 46, XY DSD; Diagnosis; Treatment46,XY 性发育异常疾病临床时有见到,其表现较复杂,外阴可呈完全女性化至完全男性化,其性染色体为 46,XY,性腺为睾丸,社会性别或男或女或模糊不定。诊断较复杂,治疗上有一定难度,影响身心较大且持久。我院 1979 年 1 月~2024 年 2 月共收治 26例,分析如下:1.1 诊断标准(1)性腺为睾丸;(2)性染色体为 46,XY。伴下列任何一项:①完全男性化合并隐睾,伴有子宫输卵管阴道。②外阴完全女性化,阴茎细小如阴蒂,外观可见到阴道开口。③会阴模棱两可,呈尿生殖窦开口,探查发现有前列囊或阴道或并有子宫、输卵管。1.2 社会性别男、女各 13 例。年龄 1~16 岁,平均 10 岁。1.3 临床表现外阴完全男性化 2 例,外阴完全女性化 5 例(外观分别有尿道、阴道开口);会阴呈单一尿生殖窦开口 19 例;睾丸在盆腔内 13 只(8 例次),位于腹股沟处 2...

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