新型包皮套扎器和缝合器包皮环切术的疗效比较  

A novel disposable ring versus the suture device in circumcision

作　　者：赵永久[1] 占鹏程[1] 陈强[1] 程伟[1] 叶福增[1] 王乙水[1] 王均均 汤忠木[1] 

机构地区：[1]杭州市萧山第一人民医院泌尿外科,浙江杭州311200

出　　处：《中华男科学杂志》2017年第12期1093-1098,共6页National Journal of Andrology

摘　　要：目的:比较新型包皮套扎器行包皮环切术与缝合器包皮环切术治疗包皮过长及包茎的临床效果。方法:470例包皮环切术的患者随机分为两组,一次性使用包皮套扎器包皮环切术(套扎器组)和缝合器包皮环切术(缝合器组)各235例。分析和比较两组患者的手术时间、术中出血量、疼痛评分(视觉模拟评分法,VAS)、术后愈合时间、阴茎头充血水肿、排尿困难或者费力、术后明显出血及血肿、包皮裂开、延迟脱钉及愈合后外观满意度等。结果:所有手术均顺利完成,套扎器组的手术时间(3.83±0.42)min、术中出血量(2.41±1.01)ml、术中疼痛评分(0.20±0.47)分,术后6 h疼痛评分(0.48±0.94)分,术后包皮愈合时间(7.79±1.65)d,愈合后外观满意度95.8%(228/235),阴茎头充血水肿2.56%(6/235),排尿困难费力2.13%(5/235),术后明显出血及血肿1.28%(3/235);缝合器组上述指标分别为(7.49±1.84)min、(3.34±2.59)ml、(0.57±0.76)分、(3.42±1.12)分、(12.05±2.80)d、90.6%(213/235)、36.17%(85/235)、34.04%(80/235)、5.11%(12/235),以上9项指标两组均有显著差异(P均<0.05)。术后第6天夜间疼痛评分套扎器组(1.34±1.07)分,缝合器组为(1.31±0.96)分;拆环时疼痛评分套扎器组(3.36±1.41)分,缝合器组脱钉前钉挂内裤时疼痛评分(3.49±1.22)分,两组差异均无统计学意义(P均>0.05)。两组均无术后明显感染及延迟愈合情况发生,包皮裂开套扎器组1例,缝合器组2例。缝合器组延迟脱钉者8(3.40%)例。结论:使用新型套扎器包皮环切术更加安全、省时、美观、患者痛苦小、护理更简单。Objective ： To investigate the clinical effect of a novel disposable ring versus that of the suture device in circumcision for redundant prepuce and phimosis. Methods： We randomly assigned 470 male patients with redundant prepuce or phimosis to re- ceive circumcision with a novel disposable ring （the DR group, n = 235 ） or the suture device （the SD group, n = 235 ） and com- pared the operation time, intraoperative blood loss, pain scores, wound healing time, and postoperative complications and penile ap- pearance between the two groups of patients. Results ： All the operations were completed smoothly. Compared with the SD group, the DR group showed significantly shorter operation time （ [ 7.49 ± 1.84 ] vs [ 3.83± 0.42 ] rain, P 〈 0. 05 ）, less intraoperative blood loss （[3.34 ± 2.59] vs [2.41 ± 1.01] ml, P 〈0.05）, lower intraoperative pain score （0.57 ± 0.76vs0.20 ± 0.47, P 〈 0.05 ） and 6-hour postoperative pain score （3.42 ±1.12 vs 0. 48± 0.94, P 〈 0.05）, shorter wound healing time （ [ 12.05 ± 2.80] vs [7.79± 1.65] d, P 〈0.05）, lower incidence rates of postoperative glans congestion or edema （36.17% [85/235] vs 2.56% [ 6/235 ], P 〈 0.05 ）, dysuria or strenuous urination （34.04% [ 80/235 ] vs 2.13 % [ 5/235 ], P 〈 0.05 ） and bleeding orhematoma （5.11% [ 12/235] vs 1.28% [3/235], P 〈0.05）, and higher satisfaction with postoperative penile appearance （90.6% ~213/235] vs 95.8% [228/235], P 〈0.05）. There were no statistically significant differences between the SD and DR groups in the pain scores at the sixth night after operation （1.31 ± 0.96 vs 1.34 ± 1.07, P 〉0.05） or while the staples scraping the under- pants or at the ring removal （3.49 ± 1.22 vs 3.36 ± 1.41, P 〉 0.05）. No obvious postoperative infection or delayed healing was observed except for 3 cases of wound dehiscence （ 1 in the DR and 2 in the SD group） and 8 cases of delayed removal of the staples in the SD group. Conclusioa ： The novel disposable ring, w

关 键 词：新型包皮套扎器 缝合器 包皮环切术 包茎 包皮过长 

分 类 号：R699.8[医药卫生—泌尿科学]