改良Duckett法加Duplay法治疗中-重度尿道下裂合并小阴茎畸形临床分析  

Clinical effect of improved Duplay combined with Duckett operation for microphallus accompanies moderate to severe hypospadias

作　　者：宋晋秋[1] 叶辉[1] 郝春生[1] 白东升[1] 牛志尚[1] 邱颖[1] 

机构地区：[1]首都儿科研究所附属儿童医院泌尿外科,北京100020

出　　处：《北京医学》2017年第7期681-683,I0001,共4页Beijing Medical Journal

摘　　要：目的探讨应用改良Duckett法加Duplay法治疗尿道下裂合并小阴茎患儿的手术方法及疗效。方法以首都儿科研究所附属儿童医院泌尿外科2014年1月至2016年8月收治的10例中-重度尿道下裂合并小阴茎的患儿为研究对象,年龄2~10岁,平均5.1岁。所有患儿行染色体检查均为46,XY。其中,重度尿道下裂合并小阴茎畸形者4例,中度尿道下裂合并小阴茎畸形者6例。应用Duckett法加Duplay法成型尿道,修剪翻转远端皮瓣覆盖阴茎头修补缺损。结果 10例手术均顺利完成。所有患儿随访6~24个月,平均13个月。术后阴茎头裂开再次手术1例,并发尿道瘘1例,并发尿道狭窄1例,其余患儿排尿通畅,尿道开口于阴茎头端,外观良好。结论采用改良Duckett法加Duplay法能有效解决尿道下裂合并小阴茎患者手术成型困难问题,手术方法效果满意,术后外观良好。Objective To investigate the clinical effect of improved Duplay combined with Duckett operation for microphallus accompanied moderate to severe hypospadias. Methods From Jan. 2014 to Aug. 2016, a total of 10 cases of microphallus were enrolled in the study including 4 cases with moderate hypospadias and 6 severe cases. The median age was 5.1（2-10） years. They were all 46XY males. For surgical procedure, Duplay combined with Duckett operation was performed, then split-skin graft for incision was turned over in the urethra located in glans penis. Results During 6-24 months following up, all 10 cases underwent operation and 7 voided smoothly, and other patients suffered from urethral stricture（1 case）, urinary fistula （1 cases）, and 1 cases was reoperated for coronal hypospadias. Conclusion Improved Du- play combined with Duckett operation is an effective treatment for microphallus accompanied moderate to severe hypospa- dias.

关 键 词：小阴茎 尿道下裂 手术 儿童 

分 类 号：R726.9[医药卫生—儿科]