采用一次性包皮环切缝合器的手术效果和术后管理  

Results and perioperative management of circular cutter with stapled anastomosis for circumcision

作　　者：方冬[1] 袁亦铭[1] 郑卫[1] 崔万寿[1] 彭靖[1] 高冰[1] 张志超[1] 辛钟成[1] 周利群[1] 郭应禄[1] 

机构地区：[1]北京大学第一医院男科中心,北京大学第一医院泌尿外科,北京大学泌尿外科研究所,北京100034

出　　处：《中国性科学》2017年第11期26-30,共5页Chinese Journal of Human Sexuality

摘　　要：目的:探讨一次性包皮环切缝合器包皮环切术后各个时间段恢复情况、术后管理和并发症处理的经验。方法:回顾性分析2015年1月至2016年1月于北大医院男科中心采用一次性包皮环切缝合器行包皮环切术的363名患者,了解患者的基本信息和围手术期处理,采集患者的术中情况和术后恢复的信息。结果:患者中位年龄28岁,平均手术时间(7.11±1.76)min,患者术后2h、术后1d和术后1周的平均VAPS评分分别为(4.06±1.19)、(2.49±0.78)和(0.22±0.48)。无严重并发症发生,主要并发症为水肿(22例)及出血(13例),水肿经纱布或自粘弹性绷带加压包扎后均缓解,出血视出血部位和出血量分别采用局部加压包扎、缝合出血点、二次手术清除血肿等方式处理后均缓解。所有患者远期恢复良好,患者对该手术的满意度较高(92.6%)。结论:采用一次性包皮环切缝合器行包皮环切术是一种安全、有效的微创方式,其术后患者满意度较高,疼痛轻,术后并发症总体发生率低,有待于术后及早发现合理处理。Objectives： To provide the perioperative management,post-operative recovery and the complications management of circumcision with circular cutter with stapled anastomosis for circumcision（ CCSAC）.Methods： The clinical data of 363 patients who received circumcision with CCSAC from Jan 2015 to Feb 2016 at Andrology Center,Peking University First Hospital was retrospectively analyzed. The baseline demographical data,perioperative management,the intro-operative data and the post-operative information were collected. Results：The median age was 29 and the mean operative time was 7. 11 ± 1. 76 minutes. The VAPS for patients at 2 hours,1 day and 1 week after surgery was 4. 06 ± 1. 19,2. 49 ± 0. 78 and 0. 22 ± 0. 48 respectively. No serious complication was found and the most common complications were edema（ 22 cases,which was treated with wrapping and bandage） and bleeding（ 13 cases,which was treated with wrapping,suturing or opening surgery）. The long-term prognosis was good for all patients and the 92. 6% patients were satisfied with the surgery. Conclusion： The CCSAC is a safe and effective minimal invasive method for circumcision. The overall complication rate is low which requires early diagnosis and proper management.

关 键 词：包皮环切术 一次性包皮环切缝合器 疼痛评分 患者满意度 

分 类 号：R699.8[医药卫生—泌尿科学]