小儿包皮外伤的个性化治疗方案  

Individualized treatment scheme for pediatric foreskin trauma

作　　者：田广超 张胜利[1] 苑思彤 王登辉 崔梦杰 楚向阳 韩晓江 范应中[1] Tian Guangchao;Zhang Shengli;Yuan Sitong;Wang Denghui;Cui Mengjie;Chu Xiangyang;Han Xiaojiang;Fan Yingzhong(Department of Pediatric Surgery,First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院小儿外科,郑州450052

出　　处：《中华整形外科杂志》2022年第5期565-569,共5页Chinese Journal of Plastic Surgery

基　　金：河南省联合重点基金项目(SBGJ202002042)。

摘　　要：目的总结小儿包皮外伤的个性化治疗经验。方法回顾性分析2019年1月至2021年3月郑州大学第一附属医院小儿外科收治的包皮外伤患儿的临床资料。治疗前首先对小儿包皮外伤进行分类和分度, 在患儿家长知情同意的情况下据此选择治疗方案。轻度损伤采取保守治疗;中度损伤行原位缝合修复术、系带成形术;重度损伤行改良包皮环切术、包皮皮瓣包皮成形术;极重度损伤行复合皮瓣(阴囊及阴阜皮肤局部推进皮瓣联合包皮皮瓣)包皮成形术。术后对患儿阴茎外观及排尿和勃起功能进行随访。结果共纳入36例男性患儿, 年龄6个月至10岁。包皮损伤类型:包皮系带损伤7例, 内板损伤7例, 外板损伤12例, 内外板复合损伤10例;包皮损伤程度:轻度损伤9例, 中度损伤6例, 重度损伤19例, 极重度损伤2例。36例中保守治疗9例, 原位缝合修复术4例, 原位缝合修复术+包皮环切术5例, 改良包皮环切术12例, 包皮皮瓣包皮成形术4例, 复合皮瓣(阴囊及阴阜皮肤局部推进皮瓣+包皮皮瓣)包皮成形术2例。所有患儿均随访3~6个月, 阴茎阴囊外形良好, 排尿、勃起功能正常, 患儿家长对治疗效果均满意。结论对于小儿包皮外伤的治疗, 需综合考虑外伤累及的包皮部位及包皮损伤的程度, 采取合适的个性化治疗方案, 可以获得较好的效果。Objective To summarize the experience of personalized treatment of pediatric prepuce trauma.Methods The clinical data of children with prepuce trauma treated in the Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University from January 2019 to March 2021 were analyzed retrospectively.First,pediatric prepuce trauma was classified and graded before treatment,and then the treatment plans were developed with the informed consent of the children’s parents.Mild injuries were treated conservatively.In moderate injuries,in situ suture repair and frenuloplasty were performed.In severe injuries,modified circumcision and prepuce flap prepuceplasty were performed.In extremely severe injuries,composite flap(scrotal and mons pubis flap combined with prepuce flap)prepuceplasty was performed.The children were followed up for penile appearance and urinary and erectile function postoperatively.Results A total of 36 male children,aged 6 months to 10 years,were enrolled in the study.Type of foreskin trauma:7 cases of foreskin tie injury,7 cases of inner plate injury,12 cases of outer plate injury,and 10 cases of combined inner and outer plate injury;degree of foreskin trauma:9 cases of mild injury,6 cases of moderate injury,19 cases of severe injury,and 2 cases of extremely severe injury.9 of the 36 cases were treated conservatively;4 cases were treated with in situ suture repair;5 cases were treated with in situ suture repair+circumcision;12 cases were treated with modified circumcision;4 cases were treated with foreskin flap penile circumcision,and composite flaps(scrotal and mons pubis flaps as advancement flap+prepuce flap)were applied in 2 cases.All the children were followed up for 3~6 months.The appearance of the penis and scrotum was good,and the urination and erectile function were normal after treatment.The parents of the children were satisfied with the treatment results.Conclusions For the treatment of pediatric prepuce trauma,it is necessary to comprehensively consider the location of th

关 键 词：包皮 创伤和损伤 儿童 保守疗法 修复外科手术 外科皮瓣 

分 类 号：R726.9[医药卫生—儿科]