重度尿道下裂一期成形术并发症及其防治  

Prevention and treatment of complications in patients with serious hypospadias repaired by one-stage urethroplasty

作　　者：孙明[1] 黄鲁刚[1] 王明和[1] 陈绍基[1] 杨宇如[1] 

机构地区：[1]四川大学华西医院泌尿外科,成都610041

出　　处：《中国医师进修杂志（外科版）》2006年第4期34-35,47,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨重度尿道下裂一期成形术后并发症发生的原因及相应的防治方法。方法收集275例重度尿道下裂患者，临床分型为阴茎阴囊型148例，阴囊型95例，会阴型32例。成形尿道长度为3．0-8．4cm，平均（4．1±0．7）cm。32例患者术前均应用内分泌激素治疗。结果一期成形术后随访1～3年，发生并发症35例，发生率为12．7％，其中尿道瘘者24例（8．7％），尿道狭窄6例（2．2％），尿道憩室3例（1．1％），残留阴茎下曲2例（0．7％）。尿瘘和尿道狭窄发生率显著高于其他并发症发生率（P〈0．05）。结论选择合适的手术方式，彻底矫治阴茎弯曲，术前行内分泌治疗，严格精细的手术操作。及时发现和修补尿瘘等均有助于降低并发症的发生率。Objective To study and analyze the cause, prevention and treatment for complications in patients with serious hypospadias repaired by one- stage urethroplasty. Methods From 1987 to 2002,275 patients with serious hypospadias were repaired by one- stage urethroplasty, there were 35 cases had complications. The classifications were penoscrotal 148 cases, scrotal 95 cases and perineal 32 cases. The lengths of new urethras were from 3.0 to 8.4 cm, the mean was （4.1 ± 0.7）an. Thirty-two cases were received endocrinotherapy before urethroplasty. Results The rate of complications was 12.7 % for 1 ～ 3 years following survey. There were urethral fistulas 24 cases （8.7 % ）, urethral strictures 6 （2.2%）, diverticulurns 3 （1.1% ）, chordees 2 （0.7%）. The rate of urethral fistulas was the first and urethral stricture was the second, they were higher than those of other complications （P 〈 0.05）. Urethral fistulas was the frequentest complication of one - stage urethroplasty for serious hypospadias. Conclusions It is important to choose feasible operation method, process carefully, endocrinotherapy before urethroplasty, detection and therapy in time for decreasing the complications of the hypospadias urethroplasty.

关 键 词：尿道下裂 重建 并发症 治疗 

分 类 号：R696[医药卫生—泌尿科学] R696.05[医药卫生—外科学]