Snodgrass尿道成形术治疗远端尿道下裂  

Sondgrass urethroplasty treatment of children with distal shaft hypospadias

作　　者：齐进春[1] 张雅楠[1] 甄鹤 张泽峰 徐辉[1] 薛文勇[1] 

机构地区：[1]河北医科大学第二医院泌尿外科,河北石家庄050000 [2]河北省沧州市人民医院医专院区肝胆胰外科,河北沧州061000

出　　处：《河北医科大学学报》2016年第8期908-910,915,共4页Journal of Hebei Medical University

摘　　要：目的观察Snodgrass尿道成形术治疗远端尿道下裂的疗效及并发症,为远端尿道下裂治疗提供依据。方法选取远端型尿道下裂患者128例,均采取Snodgrass尿道成形术,术后随访6个月以上,总结分析临床效果。结果 128例患者中手术成功101例,成功率78.9%。发生尿道瘘13例（位于冠状沟处9例,位于阴茎体4例）,发生率10.2%,经6个月后1~2次尿道瘘修补术成功修复。出现尿道狭窄9例,经2~6个月尿道扩张成功治疗8例,随访6个月以上未再次出现尿道狭窄,尿道完全闭锁1例,尿道扩张不能顺利通过,予以尿道劈开,重建尿道板,半年后再次行Snodgrass术成功治愈。出现带管期间的泌尿系感染3例,予以早期拔管,辅以静脉滴注敏感抗生素后治愈。术后出现阴茎头裂开2例,尿道外口位于冠状沟处,无狭窄,经与患儿家长充分沟通后,暂不行手术矫治,视患儿阴茎及尿道生长发育情况决定是否再次手术。所有患儿均随访6个月以上,未再次出现其他不适及并发症。结论 Snodgrass尿道成形术治疗远端型尿道下裂,取材容易,操作简便,成功率较高,并发症发生率低,值得临床推广。Objective To analyse and discuss the effects and complications of distal shaft hypospadias patients to treatment by Sondgrass urethroplasty,and to provide the basis for distal shaft hypospadias treatment.Methods One hundred and twenty-eight cases of distal shaft hypospadias patients were selected,all taked Sondgrass urethroplasty.After 6months of followup,the clinical results were analyzed.Results One hunred and twenty-eight of the 101 patients had successful operation and the success rate was 78.9%.There are 13 patients with urethral fistula（9cases located in coronary sulcus,4cases located in the shaft of penis）,the incidence rate is 10.2%.All patients with urethral fistula were repaired successfully by 1-2secondary urethral fistula repair after6 months.Urethral stricture occurred in 9patients.After 2-6months urethral expansion,8cases were successfully recovered.Urethral stricture did not appear again after 6months follow-up.There is 1case with urethral atresia completely. Urethral expansion cannot pass.By splitting the urethra and reconstructing the urethral plate,this case was successfully cured after half a year with Snodgrass.There are 3cases with urinary tract infection during intratracheal tube.By giving early extubation and supplemented by static sensitive antibiotics,the patients were cured.Besides,there were 2cases appear glans dehiscence.Urethral mouth is located in coronary ditch place without stenosis.After fullcommunication with the parents of children,not temporary surgical correction was used.Whether using the surgery again was decided by the children＇s penis and urethral growth situation.All of them were followed up for 6months or above,and no other discomfort and complications appeared.Conclusion Snodgrass urethroplasty to treat distal shaft hypospadias is easy to draw materials,simple to operate,with high success rate and low incidence of complications.It is worthy of clinical promotion.

关 键 词：尿道下裂 尿道成形术 治疗结果 

分 类 号：R695[医药卫生—泌尿科学]