带蒂软组织筋膜瓣治疗尿道下裂术后尿瘘的临床研究  

Clinical study of pedicled soft tissue fascial flap in the treatment of urinary fistula after hypospadias surgery

作　　者：汤坤彬 何少华[1] 徐迪[1] TANG Kunbin;HE Shaohua;XU Di(Department of Pediatric Surgery,Fujian Provincial Hospital,Fuzhou,Fujian,350001,China)

机构地区：[1]福建省立医院儿外科,福建福州350001

出　　处：《当代医学》2022年第30期141-145,共5页Contemporary Medicine

摘　　要：目的探讨带蒂软组织筋膜瓣加强覆盖在修补尿道下裂术后尿瘘中的作用。方法回顾性分析2006年3月至2019年4月本院收治的185例尿道下裂术后尿瘘患儿的临床资料,按照是否采用带蒂软组织筋膜瓣行尿瘘修补分为研究组(n=105)与对照组(n=80)。比较两组手术情况、术后切口感染情况、尿瘘复发情况、尿道狭窄发生情况及手术前后尿动力学指标变化情况。结果研究组手术时间长于对照组,尿瘘复发率低于对照组,成功率高于对照组,差异有统计学意义(P<0.05)。两组切口感染率、尿道狭窄发生率比较差异均无统计学意义。术后,两组最大尿流率、平均尿流率水平均高于术前,排尿时间小于术前,差异有统计学意义(P<0.05),但组间比较差异均无统计学意义。结论尿道下裂术后尿瘘手术中应加强对瘘口的软组织加强覆盖,根据瘘口位置采用不同类型的软组织筋膜瓣加强覆盖可明显提高尿道皮肤瘘修补术成功率,改善术后尿动力学指标,值得临床推广应用。Objective To investigate the effect of reinforced covering with pedicled soft tissue fascial flap in repairing urinary fistula after hypospadias.Methods The clinical data of 185 children with urinary fistula after hypospadias admitted to our hospital from March 2006 to April 2019 were retrospective analyed,and they were divided into study group(n=105)and control group(n=80)according to whether urinary fistula repair was performed with pedunculated soft tissue fascial flap.The surgical situation,postoperative incision infection,recurrence of urinary fistula,occurrence of urethral stricture and urodynamic index changes before and after surgery were compared between the two groups.Results The operation time of the study group was longer than that of the control group,the recurrence rate of urinary fistula was lower than that of the control group,and the success rate was higher than that of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in incision infection rate and urethral stricture between the two groups.After surgery,the maximum urine flow rate and average urine flow rate levels of the two groups were higher than those before surgery,and the voiding time was less than that before surgery,and the difference was statistically significant(P<0.05),but there was no significant difference between the groups.Conclusion The soft tissue reinforcement coverage of the fistula should be strengthened during urinary fistula surgery after hypospadias,and the use of different types of soft tissue fascial flap enhancement coverage according to the location of the fistula can significantly improve the success rate of urethral skin fistula repair and significantly improve the postoperative urodynamic index,which is worthy of clinical promotion and application.

关 键 词：尿瘘 尿道下裂 带蒂筋膜瓣 

分 类 号：R699.6[医药卫生—泌尿科学]