塑形环联合CO2激光包皮环切术与商环包皮环切术的临床应用比较  

Clinical efficacy of shaping ring combined with CO2 laser circumcision and Shang ring circumcision in the treatment of redundant prepuce and phimosis

作　　者：李红霞[1] 王宏[1] 杨大来[1] 汪小燕[1] Li Hongxia;Wang Hong;Yang Dalai;Wang Xiaoyan(Department of Surgery,Community Health Service Center,Beijing University of Posts and Telecomm unications,Beijing 100876,China)

机构地区：[1]北京邮电大学社区卫生服务中心外科

出　　处：《中国男科学杂志》2019年第6期36-41,共6页Chinese Journal of Andrology

摘　　要：目的比较塑形环联合CO2激光包皮环切术和商环包皮切术对包皮过长及包茎患者治疗的临床疗效。方法回顾性分析2017年11月至2019年1月有完整临床资料的320例包皮过长及包茎患者,其中195例行塑形环联合CO2激光包皮环切术(塑形环组),125例行商环包皮环切术(商环组),比较两组的手术时间、术中出血量、术后8h、24h、3~7d的疼痛评分、伤口愈合时间、术后并发症、外观满意率等指标。结果塑形环组和商环组手术时间分别为(22.76±3.62)、(3.64±1.19)min;术中出血量分别为(6.26±2.49)、(0.86±0.24)m L;术后疼痛评分8h后分别为(4.27±1.70)、(2.35±1.32),24h后分别为(4.67±1.64)、(1.22±1.41),3~7d后分别为(1.65±0.95)(4.26±2.30)分;伤口愈合时间分别为(9.22±1.25)、(19.65±2.39)。术后并发症发生情况:术后出血和血肿发生率分别为3.58%(7/195)、0%(0/125),术后两周水肿发生率分别为9.23%(18/195)、4%(5/125);伤口裂开发生率分别为1.02%(2/195)、4.8%(6/125),伤口感染发生率分别为0.51%(1/195)、3.2%(4/125);外观满意度率分别为93.85%(183/195)、97.6%(122/125)。两组在手术时间、术中出血量、术后出血和血肿、术后8h和24h疼痛评分方面商环组优于塑形环组(P<0.05)。在术后3~7d疼痛评分、伤口裂开、伤口的愈合时间上塑形环组优于商环组(P<0.05)。在术后两周水肿发生率、术后伤口感染率及外观满意度率上两组差异无统计学意义(P>0.05)。结论两种术式各有其优缺点,商环包皮环切术具有手术时间更短、术中出血量更少、术后出血和血肿发生率更低等特点,值得推广。Objective To evaluate the clinical efficacy of the shaping ring combined with CO2 laser circumcision and the Shang ring circumcision in the treatment of redundant prepuce and phimosis.Methods The clinical data of 320 patients with redundant prepuce and phimosis treated in our hospital from November 2017 to January 2019 were analyzed retrospectively.Among these patients,195 cases received the shaping ring combined with CO2 laser circumcision(the Shaping ring group)and 125 cases underwent the Shang ring circumcision(the Shang ring group).The operative time,intraoperative blood loss,the pain scores of postoperative 8 h,24 h,during 3-7 d,wound healing time,postoperative complications,appearance satisfactory rate were compared.Results For the Shaping ring group and the Shang ring group,the operative time was(22.76±3.62)and(3.64±1.19)min respectively,the intraoperative blood loss was(6.26±2.49)and(0.86±0.24)ml respectively,the postoperative pain scores were 8 h(4.27±1.70),(2.35±1.32),24 h(4.67±1.64),(1.22±1.41),and during 3-7 d(1.65±0.95),(4.26±2.30)respectively,the wound healing time was(9.22±1.25)and(19.65±2.39)respectively,the incidence of postoperative bleeding and hematoma was 3.58%(7/195)and 0%(0/125),the incidence of edema was 9.23%(18/195)and 4%(5/125),the incidence of wound dehiscence was 1.02%(2/195)and 4.8%(6/125),the incidence of wound infection was 0.51%(1/195)and 3.2%(4/125)respectively.The satisfactory rate of appearance was 93.85%(183/195)and 97.6%(122/125)respectively.The Shang ring group was superior to the Shaping ring group in operative time,intraoperative blood loss,the incidence of postoperative bleeding and hematoma,and postoperative pain scores at 8 h and 24 h(P<0.05).The Shaping ring group was superior to the Shang ring group in postoperative pain scores during 3-7 days,the incidence of wound dehiscence and the wound healing time(P<0.05).There were no statistical differences in the incidence of edema and postoperative infection,the appearance satisfactory rate between the two groups

关 键 词：包皮环切术 包皮过长 包茎 塑形环 商环 

分 类 号：R699.8[医药卫生—泌尿科学]