尿道板瓣与包皮瓣联合修复先天性尿道下裂  

Urethral plate flap combined with preputial island flap for treatment of congenital hypospadias

作　　者：刘晓吉[1] 李养群[1] 杨喆[1] 李锋永[1] 唐勇[1] 周传德[1] 陈文[1] 吕淑贞[1] 李强[1] 李森恺[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院整形二科,北京100144

出　　处：《中国美容医学》2008年第10期1429-1431,共3页Chinese Journal of Aesthetic Medicine

基　　金：卫生部临床重点学科基金资助项目(20010409)

摘　　要：目的:探讨尿道板瓣在尿道成形中的价值,提高先天性尿道下裂的一次手术成功率。方法:将残余尿道粘膜及粘膜下组织一起形成尿道板瓣,与一侧包皮岛状瓣结合形成缺损段尿道,转移另一侧包皮瓣完成阴茎腹侧创面覆盖,尿道板瓣最大面积为2.0cm×0.5cm。治疗先天性阴茎型尿道下裂患者34例。结果:本组患者除3例患者术后出现尿道外口包皮瓣部分坏死,尿道外口狭窄,二次手术切开外,余者均Ⅰ期愈合,随访1～3年,无再造尿道狭窄及尿瘘等并发症出现。结论:先天性尿道下裂患者残余尿道粘膜及粘膜下组织可以形成具有良好血供的尿道板瓣,有效地解决了一侧包皮瓣再造尿道组织量不足的问题,提高了一次手术成功率。Objective To discuss the anatomical and clinical value about the urethral plate flap in hypospadias repair. Methods Total 34 patients with penile hypospadias were included in the study. The urethral plate flap was formed by the hypoplastic urethral mucosa and submucous tissue. The distal urethra was reconstructed by urethral plate flap combined with one side preputial island flap. Then the other side preputial was transferred to cover the ventral wound of penis. The maximum area of urethral plate flap was 2.0cm×0.5cm. Results The follow-up period ranged from 1 to 3 years. After operation,most patients obtained satisfactory results.Yet 3 cases showed external orifice stricture of urethra, which were corrected by meatotomy. Conclusions In congenital hypospadias, the urethral plate flap has abundant blood supply and may be used to rebuilt new urethra, This method may solve the problem of insufficient local tissue and improve the operative successful rate.

关 键 词：尿道下裂 包皮瓣 尿道板瓣 

分 类 号：R699.8[医药卫生—泌尿科学]