尿道下裂包皮血管分布及其与术后近期并发症的相关性研究  

Blood vessel distribution of foreskin in children with hypospadias and its correlation with postoperative early complications

作　　者：赵彰 孙宁[1] 张潍平[1] 白继武[1] 田军[1] 李明磊[1] 宋宏程[1] 李宁[1] 

机构地区：[1]首都医科大学附属北京儿童医院泌尿外科,100045 [2]广州市妇女儿童医疗中心

出　　处：《中华小儿外科杂志》2012年第3期183-187,共5页Chinese Journal of Pediatric Surgery

基　　金：首都医学发展基金资助（编号：2009-1045）

摘　　要：目的通过对尿道下裂患儿包皮及皮瓣血管蒂的血管分布进行研究，评估并重新认识成形尿道材料的血运情况。术后对患儿随访，了解近期并发症的发生情况，探讨包皮血管分布与近期并发症的相关性，评估手术效果。方法利用冷光源透照包皮法记录血管的分布及数量并进行归纳、分析、总结。术后对行Duckett或Duckett＋Duplay手术治疗的患儿进行随访。结果包皮浅筋膜深层血管分布类型：①1支主导血管，占42．4％0；②2支主导血管，占34．7X；③3支主导血管，占13．6％；④多支主导血管（主导血管〉3支），占2．5％；⑤无明确主导血管，占6．8％。在有主导血管的病例中，主导血管的数目与尿道瘘及尿道狭窄的发生率无明确关系。结论尿道下裂患儿包皮浅筋膜深层血管分布可分为五个类型。浅筋膜深层血管分布类型与尿道下裂的严重程度无明确对应关系。包皮血管分布对Duckett整体手术效果影响很小。Objective To study the blood vessels distribution of foreskin in ehildren with hypos- padias and vesselpedicle, aiming to evaluate and recognize blood supply after application of urethra re- construction materials. Follow up study was conducted after surgery and early complications were in vestigated to evaluate the correlation between blood vessel distribution of foreskin and early complica- tions, as well as the therapeutic efficacy. Methods Duckett and Duckett ＋ Duplay procedures were performed for the children with hypospadias. The cold lighting transmission techniques was utilized to record and evaluate the distribution of blood vessels in foreskins, and followed by summarization and analysis. The follow up was conducted for patients. Results Various blood vessels distribution could he found in superficial fascia in foreskin, in which simple main branch blood vessel type was 42. 4 per cent, double main branches type was 34. 7 percent, three main branches types in them was 13.6 per cent, and multi-branches type was 2. 5 percent. Furthermore, 6. 8 percent of them were not found to have branch blood vessel. Among all cases with branches blood vessels, there were no correlations be- tween the number of branch blood vessels and incidences of fistula or stricture. Conclusions Blood vessels distribution could be classified into 5 types according to the number of branch blood vessels in superficial fascia in foreskin, and no correlations between blood vessel distribution type and severity of hypospadias. The distribution of blood vessel in foreskin has less effect on the operative efficacy.

关 键 词：尿道下裂 包皮 手术后并发症 

分 类 号：R699[医药卫生—泌尿科学]