3种包皮环切器的临床应用比较分析  

A comparative study of three different circumcision devices for redundant prepuce and phimosis

作　　者：张铭 WEI Li-juan ZHANG Ming;WEI Li-juan(Department of Urology,Three Gorges Hospital of Chongqing University,Chongqing 404000,China;Department of Pharmacy,Three Gorges Hospital of Chongqing University,Chongqing 404000,China)

机构地区：[1]重庆大学附属三峡医院泌尿外科,重庆404000 [2]Department of Pharmacy,Three Gorges Hospital of Chongqing University,Chongqing 404000,China

出　　处：《中华男科学杂志》2021年第8期729-732,共4页National Journal of Andrology

摘　　要：目的:比较一次性枪式钛钉包皮环切吻合器、一次性包皮环切吻合器和一次性双手柄包皮缝合器环切术治疗包皮过长或包茎患者的临床效果对比。方法:回顾性分析2018年9月至2020年7月在各科室及门诊行包皮环切术的150例患者临床资料。分为一次性枪式钛钉包皮环切吻合器组(枪式吻合器组,n=50)、一次性包皮环切吻合器(环切吻合器组,n=50)和一次性双手柄包皮缝合器(手柄缝合器组,n=50)。比较3种手术的手术时间,术中出血量,伤口完全愈合时间,术中、术后1 h和7 d的视觉疼痛评分,患者术后外观满意度及术后并发症发生率等指标。结果:枪式吻合器组和手柄缝合器组患者手术时间显著长于环切吻合器组(P<0.05),但两组伤口愈合时间显著短于环切吻合器组(P<0.05);枪式吻合器组和环切吻合器组患者术中出血量显著少于手柄缝合器组(P<0.05);3组患者在术后外观满意度方面无明显差异(P>0.05)。环切吻合器组和手柄缝合器组术中及术后1 h和7 d的视觉模拟评分、术后并发症发生率均大于枪式吻合器组(P<0.05)。手柄缝合器组的脱钉速度显著慢于枪式吻合器组(P<0.05)。结论:枪式吻合器治疗包皮过长或包茎患者的临床效果更具优势,在根据患者包皮结构情况和尊重患者意愿前提下,值得临床推广应用。Objective:To compare the clinical effects of disposable titanium nail circumcision stapler(TNCS),one-off circumcision stapler(Shang Ring)and disposable double-handle circumcision suture device(DHCSD)in the treatment of redundant prepuce and phimosis.Methods:We reviewed the clinical data on 150 cases of redundant prepuce or phimosis treated with the TNCS(n=50),DHCSD(n=50)or Shang Ring(n=50)from September 2018 to July 2020.We compared the operation time,intraoperative blood loss,wound healing time,Visual Analogue Scale(VAS)scores during and at 1 hour and 7 days after operation,postoperative complications and the patients’satisfaction with postoperative penile appearance among the three groups.Results:The operation time was significantly longer(P<0.05)but the wound healing time remarkably shorter(P<0.05)in the TNCS and DHCSD groups than in the Shang Ring group.The intraoperative blood loss was markedly less in the TNCS and Shang Ring groups than in the DHCSD group(P<0.05).No statistically significant difference was observed in the patients’satisfaction with postoperative penile appearance among the three groups(P>0.05).The VAS scores during and at 1 hour and 7 days after operation and the incidence rate of postoperative complications were significantly higher in the Shang Ring and DHCSD groups than in the TNCS group(P<0.05).Conclusion:The disposable titanium nail circumcision stapler is superior to disposable double-handle circumcision suture device and Shang Ring in the treatment of redundant prepuce and phimosis and deserves clinical promotion and application.

关 键 词：包皮环切器 包皮环切术 包茎 包皮过长 临床效果 

分 类 号：R691[医药卫生—泌尿科学]