包皮切割缝合器在儿童包茎术中的应用及术后并发症的治疗策略  

Treatment strategy of intraoperative and postoperative complications by surgery with circumcision suture device in children phimosis

作　　者：周其赵[1] 吴荷花[1] 夏慧[1] 薛康颐[1] 卞军[1] 刘存东[1] 杨建昆[1] 

机构地区：[1]南方医科大学第三附属医院泌尿外科,广州市510630

出　　处：《实用医学杂志》2016年第21期3537-3539,共3页The Journal of Practical Medicine

基　　金：广东省自然科学基金-博士启动项目(编号:2016A030310393)

摘　　要：目的：探讨包皮切割缝合器在儿童包茎术中的应用及术后并发症的治疗策略．以期更好地为临床工作服务。方法：回顾性分析258例儿童包茎的临床资料，均采用一次性包皮切割缝合器完成手术．术中有112例患儿包皮外口狭窄非常明显，分别采用传统的背侧剪开置入切割缝合器行切割缝合及背侧剪开置入切割缝合器后1号线缝合切口再行切割缝合两种方法进行，术后随访2～4周，收集临床资料及术中、术后并发症的治疗策略并进行统计分析．同时与86例包茎儿童采用传统包皮环切术的治疗效果进行比较。结果：所有患儿均顺利完成手术，包皮切割缝合器纽手术时间更短，出血更少。术后外观满意度更高．与传统包皮环切术组相比具有明显统计学差异（P〈0．05）；包皮切割缝合器组术中采用背侧剪开置入切割缝合器后1号线缝合组患儿术中出血更少，术中伤口再缝合发生率更低，术中切除包皮长度更易控制．术后外观满意度更加良好，与背侧剪开置入切割缝合器组相比具有明显统计学差异（P〈0．05）；术中有8例患儿包皮切割缝合器切割后包皮系带局部出血或局部皮肤缝合不佳，予5—0可吸收线局部间断缝合及止血：术后有1例患儿包皮伤口缝合钉1个月后仍不脱落，在局麻下行手工拆除缝合钉。结论：包皮切割缝合器在儿童包茎术中及术后并发症较少，使用过程非常安全、高效，具有手术时间短、出血少、外观良好等特点．在临床中值得推广应用。Objective To explore the treatment strategy of intraoperative and postoperative complications by surgery with circumcision suture device in children phimosis and better serve the chnical work. Methods Clinical data of 258 children with phimosis which were operated by disposable circumcision suture device were retrospectively analyzed. Foreskin mouth of 112 children in all the cases were found to be narrow. Traditional dorsal cut applied and circumcision suture device in the foreskin was put for operation. Another method was to suture the wound by NO.I silk after cutting the Foreskin mouth and putting circumcision suture device. All children were followed up for 2 - 4 weeks to collect and analyze clinical data, intraoperative and postoperative complications. Clinical effect of circumcision suture device with traditional circumcision suture on 86 cases were compared. Results All patients underwent through operation successfully. Compared with traditional circumcision, average operation time recorded when anesthesia worked was shorter, the hemorrhage was less, and the appearance were better in circumcision suture device group. There was less hemorrhage, lower incidence of intraoperative wound sutured. It was easier to control and cut the length of foreskin, and appearance was better in intraoperative use of NO.1 silk group. Compared with another group, there was significantly statistical difference （P 〈 0.05）. 8 patients manifested a small amount of bleeding or poor stitching after sutured by 5-0 absorbable suture. 1 patient had wound staples after circumcision for 1 month and was splinted under local anesthesia. Conclusions The intraoperative and postoperative complications operated by circumcision suture device were lower. Circumcision suture device is worth using widely because of safety and efficiency, short operation time, less hemorrhage and better appearance.

关 键 词：包皮过长 包茎 包皮环切术 儿童 

分 类 号：R726.9[医药卫生—儿科]