镶嵌式唇黏膜和膀胱黏膜修复复杂性尿道皮肤瘘的临床疗效分析  

Inlaid labial versus bladder mucosal graft repair for complex urethral skin fistula

作　　者：吕军[1] 温海东[1,2] 彭天洲 张小明[1] 沈文[1] 吴义高[1] 薛永平[1] 

机构地区：[1]广州军区广州总医院泌尿外科/全军泌尿外科中心,广东广州510010 [2]广东医科大学研究生院,广东湛江524000 [3]暨南大学医学院,广东广州510632

出　　处：《中华男科学杂志》2016年第7期621-625,共5页National Journal of Andrology

摘　　要：目的:比较镶嵌式唇黏膜和膀胱黏膜在治疗尿道下裂手术后复杂性尿道皮肤瘘手术成功率和并发症发生率。方法:对符合手术指征的55例尿道下裂术后复杂性尿道皮肤瘘患者,随机分成唇黏膜取材组(36例)和膀胱黏膜取材组(19例),于术中分别应用自体游离唇黏膜和膀胱黏膜行尿道成形术,并评估手术并发症和术后尿道皮肤瘘的再发率。结果:镶嵌式唇黏膜和膀胱黏膜在治疗复杂性尿道皮肤瘘术后,均有2例出现尿道皮肤瘘,1例出现尿道狭窄,手术成功率分别为91.7%、84.2%,无统计学差异(P>0.05);术后阴茎外形美观。两组术后并发症发生率也无统计学差异(11.1%vs 26.3%,P>0.05)。结论:镶嵌式唇黏膜和膀胱黏膜修复复杂性尿道皮肤瘘均取得了理想的效果,但唇黏膜修复供材区创伤更小,手术简单快捷,值得在临床上推广应用。Objective： To compare the effect of inlaid labial mueosal graft repair （LMGR） with that of bladder mucosal graft repair （BMGR） in the treatment of complex urethral skin fistula after hypospadias repair. Methods ： This study included 55 cases of complex urethral skin fistula following hypospadias repair. We rartdomly assigned them to receive inlaid LMGR （ n = 36 ） or BMGR （n = 19）. After surgery, we compared the incidence of complications and recurrence rate of urinary fistula between the two groups of patients. Results ： The success rates of operation were 91.7% and 84.2% in the LMGR and BMGR groups, respectively, and the penile appearance was desirable in both groups. Postoperative complications included 2 cases of urinary fistula and 1 case of urethral stricture in each group. There were no statistically significant differences between the two groups in the success rate of operation （P 〉 0.05） or the incidence rate of postoperative complications （P 〉 O. 05）. Conclusion ： Both inlaid LMGR and BMGR yield satisfactory results in the treatment of complex urethral skin fistula. However, LMGR involves less injury in mucosa collection and is easier to per- form and therefore deserves more clinical attention.

关 键 词：唇黏膜 膀胱黏膜 尿道下裂 复杂性尿道皮肤瘘 

分 类 号：R699.6[医药卫生—泌尿科学]