先期包皮环切对远段型尿道下裂患儿尿道修复疗效的影响  

Effect of Pre-Circumcision on the Outcomes of Distal Hypospadias Repair

作　　者：陈锋[1] 魏孝钰[1] 陈小华[1] 汪洋[1] 赖彩民[1] 

机构地区：[1]福建医科大学附属协和医院小儿外科,福建福州350001

出　　处：《武汉大学学报（医学版）》2014年第6期955-957,共3页Medical Journal of Wuhan University

摘　　要：目的:探讨先期包皮环切是否会增加远段型尿道下裂患儿尿道修复的并发症。方法:确诊远段型尿道下裂56例,分为两组,先期包皮环切组:在外院行包皮环切后发现尿道下裂26例;未包皮环切组:30例患儿尿道手术之前未行包皮环切术。所有病例均采用尿道板纵切卷管成型术(Snodgrass)联合阴茎背侧筋膜瓣修复尿道下裂,分析比较两组病例的手术疗效及术后并发症。结果:先期包皮环切组一次手术成功率为88.5%(23/26),未包皮环切组一次手术成功率为90.0%(27/30),两组一次手术成功率差异无统计学意义(χ2=0.034 5,P>0.05)。未包皮环切组患儿手术时间、术中出血量、住院时间均少于先期包皮环切组(t=4.249,t=7.507,t=2.147,均P<0.05)。两组尿瘘、尿道狭窄、阴茎扭转发生率差异无统计学意义(P>0.05)。结论:尿道下裂术前不应行包皮环切,会增加尿道修复的难度,这是共识,但对于远段型尿道下裂,本研究显示先期包皮环切并没有使尿道下裂的手术成功率降低、术后并发症增加。Objective：To determine whether or not circumcision prior to distal hypospadias repair increases the risk and/or complications.Methods：Hypospadias cases including 26 circumcised patients and 30 children without a history of circumcision were enrolled in this study,and underwent surgery for hypospadias repair using Snodgrass＇ s operation style combined penile dorsal fascia flap.Results：The primary success rate was 88.5%in circumcised group and 90.0%in uncircumcised group,without significant difference（χ^2=0.034 5,P〉0.05）.The mean duration of surgery,the blood loss,and hospitalization in uncircumcised group were all shorter or less than in circumcised group（t=4.249,t=7.507,t=2.147,all P〈0.05）.No significant difference was found in the incidence of urinary fistula,urethral stricture,and penis twisting.Conclusion：It is well accepted that infants with hypospadias should wait for circumcision until the reconstructive surgery for hypospadias,although postoperative complications in circumcised distal hypospadias patients do not increase.

关 键 词：尿道下裂 SNODGRASS术 包皮环切 

分 类 号：R726.9[医药卫生—儿科]