小儿包茎病理基础及早期微创治疗的临床研究  

The clinical study of pathological foundation and early mini-invasive treatment on pedo-phimosis

作　　者：张永玉[1] 苗小金 张喜清[1] 李军[1] 董岩[1] 张锐利[1] 高胜海[1] 

机构地区：[1]威海市立医院医学美容科,山东威海264200

出　　处：《中国美容整形外科杂志》2010年第9期547-549,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的研究小儿包茎的病理基础，探讨小儿包茎治疗的新方法。方法采用电离子手术治疗机，在106例包茎患儿的阴茎背部正中线上纵行切开包皮内、外板至距冠状沟0．5～1．0cm处，即可在冠状沟偏后方皮下见有明显的紧缩环，并将其切断，使包皮上下移动更为容易；切口处酌情去除一三角形皮瓣，内、外板对位缝合，形成一小扇形缺损。将部分紧缩部位皮肤及皮下组织切除，用10％甲醛固定后送病理检查。结果本组患儿共106例，其中54例患儿包茎的紧缩环病理显示为增生性纤维结缔组织、平滑肌纤维及神经纤维组织，其中以纤维结缔组织和平滑肌纤维为主。所有患儿术后均随访6～24个月，其阴茎头部半露，包皮容易上翻，无不良反应发生。结论包茎患儿在冠状沟偏后方皮下存在较明显的紧缩环，其病理为增生性纤维结缔组织、平滑肌纤维；早期微创解除包皮紧缩环治疗小儿包茎，较传统的手术方法痛苦小、满意度高。Objective To study the pathological foundation about pedo-phimosis and explore its new treatment. Methods The ionizing therapeutic machine was adopted to treat the pedo-phimosis on 106 cases. The operative procedure was following： vertical cut was performed along the dorsal midline of penis ; contractus annulation was found between the internal and external plates of prepuce which were 0.5 - 1.0 cm away from the atrioventricular furrow, on subentaeous behind atrioventricular furrow ; the annulation was cut to make the prepuce move upward and downward easily; triangle flap was removed appropriately and the internal and the external plates were performed the apposition suture to form a fan-shaped defect. The contractus skin and subcuta- neous tissue was cut which were fixed up with 10% formalin for pathologic test. Results The pathologic re- sults of 54 children showed the contractus link was composed of hyperplastic fibrous connective tissue, smooth muscle fiber tissue and nerve fiber tissue, and the main were hyperplastic fiber and smooth muscle fiber tissue. All children were satisfied with the half-exposed glans penis, easy prepuce movement and non-adverse reaction after 6 - 24 months follow-up. Conclusion The contractus link of pedo-phimosis is located on subcutaneous behind atrioventricular furrow which pathologic results are fibrous connective tissue and smooth muscle fiber tissue; compared with the traditional method, the mini-invasive treatment of the eontractus annulation removal is accepted easily with little pain and high satisfaction.

关 键 词：小儿包茎 病理基础 包皮紧缩环 微创 

分 类 号：R322.6[医药卫生—人体解剖和组织胚胎学]