改良包皮环切术临床疗效及意义  

The clinical efficacy and significance of modified circumcision

作　　者：黄怡 原劲杨[1] 赵维明[1] 金承俊[1] 夏舜尧[1] 修有成[1] HUANG Yi;YUAN Jin-yang;ZHAO Wei-ming;JIN Cheng-jun;XIA Shun-yao;XIU You-cheng(Department of Urology,First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院泌尿外科

出　　处：《现代泌尿外科杂志》2019年第6期441-444,共4页Journal of Modern Urology

摘　　要：目的比较传统包皮环切术、改良包皮环切术、包皮环切缝合器治疗包茎及包皮过长的临床疗效。方法系统回顾我院泌尿外科门诊行传统包皮环切术(n=106)、改良包皮环切术(n=110)、包皮环切缝合器(n=125)治疗包茎及包皮过长341例患者的临床资料,比较3种术式的手术时间、术中出血量、术后3h和6d疼痛评分、术后并发症、完全愈合时间、患者满意度(手术满意度、恢复满意度、外观满意度)、手术费用。结果传统术组手术时间为(22.0±2.6)min,改良术组为(12.1±3.1)min,缝合器组为(6.8±2.5)min;术中出血量分别为(13.6±2.4)mL、(7.6±3.5)mL、(2.6±1.3)mL,3组间比较差异有统计学意义(P<0.05);改良术组和缝合器组术后3h疼痛评分低于传统术组(P<0.05);各组术后6d疼痛评分和完全愈合时间相比无显著性差异(P>0.05);改良术组和传统术组的手术费用及恢复满意度优于缝合器组(P<0.05);改良术组和缝合器组的手术满意度优于传统术组(P<0.05);改良术组和缝合器组的外观满意度优于传统术组,而术后并发症较传统术组少(P<0.05)。结论改良包皮环切术的临床疗效确切,操作简单,手术费用低,术后并发症少,外形美观,值得临床推广。Objective To compare the clinical efficacies of traditional circumcision,modified circumcision and circumcision stapler in the treatment of phimosis and redundant prepuce. Methods The clinical data of the 341 patients with phimosis and redundant prepuce were retrospectively analyzed,including 106 treated with traditional circumcision,110 with modified circumcision and 125 with circumcision stapler.The operation time,intraoperative blood loss,3-hour and 6-day postoperative pain scores,postoperative complications,incision healing time,patients satisfaction (surgical,recovery and appearance),and surgical costs were compared among the three groups. Results The operation time was (22.0±2.6) min,(12.1±3.1) min,and (6.8±2.5) min in the traditional,modified,and circumcision stapler groups,respectively ( P <0.05).The intraoperative blood loss was (13.6±2.4) mL,(7.6±3.5) mL and (2.6±1.3) mL,respectively ( P <0.05).The modified and circumcision stapler groups had lower 3-hour postoperative pain score than the traditional group ( P< 0.05).There were no significant differences in the 6-day postoperative pain score and incision healing time among the three groups ( P >0.05).The traditional and modified groups had lower surgical costs but higher recovery satisfaction than the circumcision stapler group ( P< 0.05).The modified and circumcision stapler groups had higher surgical satisfaction than the traditional group ( P< 0.05).The modified and circumcision stapler groups had higher appearance satisfaction but lower incidence of complications than the traditional group ( P< 0.05). Conclusion The modified circumcision is safe and effective,with advantages of simple operation,low surgical costs,few complications,and nice physical appearance.Therefore,it is worth of clinical promotion.

关 键 词：包皮环切术 包皮过长 包茎 

分 类 号：R697.1[医药卫生—泌尿科学]