改良Koyanagi术式一期治疗重型尿道下裂的疗效评价  

Evaluation of curative effect of modified Koyanagi operation for primary treatment of male children with severe hypospadias

作　　者：许俊杰 刘星[2] 刘丰[2] 张德迎[2] 陆鹏[2] 吴盛德[2] 李旭良[2] 华燚[2] Xu Junjie;Liu Xing;Liu Feng;Zhang Deying;Lu Peng;Wu Shengde;Li Xuliang;Hua Yi(Chongqing Medical University,Academy of Pediatrics,Chongqing 400014,China;Department of Urology,Children's Hospital of Chongqing Medical University,Ministry of Education Key Laboratory of Child Development and Disorders,China International Science and Technology Cooperation Base of Child development and Critical Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering,Chongqing 400014,China)

机构地区：[1]重庆医科大学儿科学院儿外科,重庆市400014 [2]重庆医科大学附属儿童医院泌尿外科,儿童发育疾病研究教育部重点实验室,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室,儿童泌尿生殖发育与组织工程重点实验室,重庆市400014

出　　处：《临床小儿外科杂志》2020年第3期228-235,共8页Journal of Clinical Pediatric Surgery

基　　金：国家自然科学基金项目(编号:81370782);重庆医科大学院级临床研究项目(编号:儿院(2015)45号-lcyj2015-5)。

摘　　要：目的评价改良Koyanagi术式一期治疗重型尿道下裂的疗效。方法回顾性总结重庆医科大学附属儿童医院2009年2月至2018年10月151例采用Koyanagi术式(为Koyanagi组)和188例采用Duckett术式(为Duckett组)治疗的重型尿道下裂患儿临床资料,对两种术式的治愈率、并发症发生情况进行比较分析,评价我院改良Koyanagi术式的疗效。结果Koyanagi组发生尿瘘17例,尿道狭窄15例,尿道憩室2例,尿道感染3例,伤口裂开2例;Duckett组发生尿瘘37例,尿道狭窄27例,尿道憩室6例,尿道感染11例,伤口裂开6例;Koyanagi组治愈率显著高于Duckett组,尿瘘发生率显著低于Duckett组(P<0.05)。两组家长对外观的满意度均显著低于非手术泌尿外科医师(P<0.05)。结论我院的改良Koyanagi术式操作更简便,术后并发症少,术后阴茎外观较好,治疗重型尿道下裂疗效确切,可作为治疗重型尿道下裂的新选择。Objective To evaluate the curative efficacy of modified Koyanagi procedure for severe hypospadias.Methods The clinical data were retrospectively reviewed for Koyanagi operation(n=151)versus and Duckett s procedure(n=188)for severe hypospadias from February 2009 to October 2018.The curative rates and complications of two operations were compared and the efficacy of modified Koyanagi operation was evaluated.Results In Koyanagi group,there were urinary fistula(n=17),urethral stricture(n=15),urethral diverticulum(n=2),urethral infection(n=3)and wound dehiscence(n=2);In Duckett group,urinary fistula(n=37),urethral stricture(n=27),urethral diverticulum(n=6),urethral infection(n=11)and wound dehiscence(n=6).The curative rate was significantly higher in Koyanagi group than that in Duckett group.And urinary fistula rate was significantly lower than that in Duckett group(P<0.05).Parental satisfaction with appearance was significantly lower than that of non-operative urologists(P<0.05).Conclusion The modified Koyanagi procedure is more convenient with fewer postoperative complications and better postoperative penile appearance.The curative efficacy is definite for severe hypospadias is accurate.Up to the international level,it may be employed as a new option for treating severe hypospadias.

关 键 词：重型尿道下裂 外科手术 治疗结果 

分 类 号：R726.9[医药卫生—儿科] R695[医药卫生—临床医学]