游离包皮内板嵌入式移植尿道成形术的临床应用研究  

The clinical research of inlay internal preputial graft urethraoplasty for hypospadias

作　　者：吴玉婷[1] 张兆林[1] 赖余进 袁源湖[1] 肖日海[1] 张国玺[1] 伍耿青[1] 黄若辉 曾庆明[1] 邹晓峰[1] WU Yu-ting;ZHANG Zhao-lin;LAI Yu-jin;YUAN Yuan-hu;XIAO Ri-hai;ZHANG Guo-xi;WU Geng-qing;HUANG Ruo-hui;ZENG Qing-ming;ZOU Xiao-feng(Department of Urology,The First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000;Department of Urology,Longnan Women and Children’s Hospital,Longnan,Jiangxi 341700)

机构地区：[1]赣南医学院第一附属医院泌尿外科,江西赣州341000 [2]龙南妇幼保健院,江西龙南341700

出　　处：《赣南医学院学报》2021年第1期61-64,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨游离包皮内板嵌入式移植技术在保留尿道板尿道成形术中的临床应用价值。方法:回顾性分析2016年2月至2020年2月行尿道板纵切卷管尿道成形术(TIP)及游离包皮内板嵌入式移植尿道成形术(IIPG)的尿道下裂病例178例,均为初次手术一期尿道成形。根据手术方式不同和尿道板缺损长度不同将178例患者分为4组,其中A组为行TIP手术组,按尿道板缺损长度分为A1组(缺损长度<1.5 cm)42例,A2组(1.5 cm<缺损长度<2.5 cm)48例;B组为行IIPG手术组,按尿道板缺损长度分为B1组(缺损长度<1.5 cm)41例,B2组(1.5 cm<缺损长度<2.5 cm)47例。术后均随访6个月。比较两种术式术后尿道瘘、尿道狭窄发生率。结果:所有患者一期手术成功。拔除尿管后,随访6个月结果显示,A1组与B1组比较,B1组尿道狭窄及尿瘘发生率小于A1组,差异无统计学意义(P>0.05);A2组与B2组比较,B2组尿道狭窄及尿瘘发生率小于A2组,差异有统计学意义(P<0.05)。结论:保留尿道板尿道成形术中,对于尿道板缺损长度大于1.5 cm小于2.5 cm者,使用游离包皮内板嵌入式移植技术可减少尿道瘘、尿道狭窄等术后并发症的发生。Objective:To evaluate the value of inlay internal preputial graft urethraplasty in patients with primary hypospadias.Methods:To compare the complications of inlay internal preputial graft urethraoplasty and tubularized incised plate urethroplasty by postoperative follow-up observation.Between February 2016 and February 2020,surgical technique and outcomes in 178 patients with primary distal hypospadias were reported.All patients underwent primary onestage urethraplasty.A total of 90 patients(Group A)underwent inlay internal preputial graft urethraoplasty,in which,42 patients’urethra defect length were<1.5 cm(Group A1),and the other 48 patients'urethra defect length were between 1.5 cm and 2.5 cm(Group A2).Another 88 patients(Group B)underwent tubularized incised plate,in which,41 patients’urethra defect length were<1.5 cm(Group B1),and the other 47 patients'urethra defect length were between 1.5 cm and 2.5 cm(Group B2).They were followed up for 6 months.Results:178 patients were successfully completed.The postoperative complications showed statistically significant difference between group A2 and B2(P<0.05),and no statistically significant difference between group A1 and B1(P>0.05).Conclusion:The inlay internal preputial graft urethraoplasty is feasible with fewer complications for primary distal hypospadias with the length of urethra defect between 1.5 cm and 2.5 cm.

关 键 词：尿道下裂 尿道成形术 尿道瘘 尿道狭窄 

分 类 号：R699.6[医药卫生—泌尿科学]