小儿不同年龄阶段包皮环切术式选择及评价  

The operative selection and evaluation of circumcision in children of different ages

作　　者：王军[1] 陈贵友 张亚伟 马慧 郭晖[1] 雷伟 李刚 李爽[1] WANG Jun;CHEN Guiyou;ZHANG Yawei(Department of Urology,Wuhan Children's Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院泌尿外科,430016 [2]湖北省武穴市妇幼保健院小儿外科

出　　处：《临床外科杂志》2021年第9期876-879,共4页Journal of Clinical Surgery

基　　金：武汉市卫生计生委科研立项资助项目(2014-WX14C51)。

摘　　要：目的探讨小儿不同年龄阶段包皮环切手术方式选择的重要性与合理性。方法收集我院自2019年1~9月泌尿外科病房及日间手术区完成的包皮环切手术患儿临床资料,共1440例,年龄3~16岁,其中学龄前儿童共280例,学龄期儿童620例,青春期儿童240例。在各年龄段中按不同手术方式分为传统组、套扎器组、环套术组和缝合器组。比较各组出血量、手术时间、疼痛持续时间、脱落时间、近期并发症、远期并发症。结果对于学龄前的患儿,传统手术的疼痛时间短,脱落时间短,近期并发症少。对于学龄期患儿,采用套扎器手术所用的手术时间和出血量少,近期并发症少。对于青春期患儿,采用包皮缝合器行包皮环切术所用的手术时间短,出血量少,疼痛时间短,远期并发症少。结论随着包皮环切器械的发展,小儿包皮环切术不同年龄阶段应采取不同手术方式,我们推荐学龄前儿童采用传统手术,学龄期儿童采用套扎器进行手术,青春期儿童宜选用缝合器行包皮环切术。Objective To evaluate the significance and reasonability of select in various types of circumcision in children of different ages.Methods A retrospective analysis was performed for 1440 children of different ages(3-15 years)between Jan 2019 and Sep 2019 in urological ward and ambulatory surgery area of our hospital.280 were preschool children,620 were school-age children,240 were adolescent children.In different ages,divide them into 4 groups by different types of circumcision:traditional circumcision group,circumcision group with ligation device,circumcision group with anastomoses device,circumcision group with stitching instrument.The indications such as blood loss、operating time、pain duration、shedding time、short-term complication and long-term complication were compared.Result Among the 4 surgical procedures,preschoolers had the shortest pain duration,shedding time and fewer short-term complication.School-age children had the lowest operative time and blood loss by circumcision with ligation device.Adolescent children had lower operative time,blood loss and the fewer long-term complication by circumcision with stitching instrument.Conclusion With the development of circumcision apparatus,different surgical methods should be adopted for children’s circumcision in combination with different age.Traditional circumcision should be recommended for preschoolers,circumcision with ligation device for school-age children,circumcision with stitching instrument for adolescent children.

关 键 词：包皮环切术 手术方法 包皮环切器械 儿童 

分 类 号：R726.9[医药卫生—儿科]