渐进皮瓣转移联合带蒂皮瓣转移治疗儿童重度先天性隐匿性阴茎效果评价  

Evaluation on the effect of progressive flap transfer combined with pedicled flap transfer in the of severe concealed penis in children

作　　者：闫鹏飞 席錾[1] 何魏 宋彭丽 张海洋[1] 宋翠萍[1] YAN Peng-fei;XI Zan;HE Wei;SONG Peng-li;ZHANG Hai-yang;SONG Cui-ping(Department of Pediatric Surgery,The First Affiliated Hospital,Xinxiang Medical University,Weihui 453100,China)

机构地区：[1]新乡医学院第一附属医院小儿外科,卫辉453100

出　　处：《天津医科大学学报》2023年第6期651-655,共5页Journal of Tianjin Medical University

基　　金：新乡市科技攻关项目(GG2021031,CXGG17006)。

摘　　要：目的:评价渐进皮瓣转移联合带蒂皮瓣转移治疗儿童重度隐匿性阴茎临床效果。方法:回顾性分析2019年2月—2022年11月在新乡医学院第一附属医院小儿外科行手术治疗的重度隐匿性阴茎患儿72例。分为观察组(n=48)和对照组(n=24),观察组采用渐进皮瓣转移联合带蒂皮瓣转移术,对照组采用Brisson术。记录两组平均手术时间、平均住院时间、术中出血量、阴茎延长长度、包皮水肿时间、切口感染率及家属满意度。结果:对照组1例阴茎回缩,其余手术均成功。观察组阴茎延长长度、包皮水肿时间、平均住院时间、平均手术时间、家属满意度得分分别为(2.85±0.29)cm、(45.88±3.61)d、(7.75±2.81)d、(73.21±4.89)min、(8.38±0.97)分,对照组分别为(2.43±0.43)cm、(52.38±5.24)d、(9.21±2.08)d、(67.71±4.56)min、(7.50±1.64)分,差异有统计学意义(t=4.267、-5.464、-2.249、5.598、2.852,均P<0.05);观察组术中出血量、术后皮瓣感染率、术后满意率分别为(6.29±1.64)mL、2.1%、95.8%,对照组分别为(6.83±1.90)mL、4.2%、83.3%,差异不显著(t=-1.253、0.529、1.841,均P>0.05)。结论:渐进皮瓣转移联合带蒂皮瓣转移在一定程度上解决了重度隐匿性阴茎患儿阴茎体皮肤覆盖问题,术后包皮水肿轻、外形美观,尤适用于阴囊皮肤条件差的重度隐匿性阴茎。Objective:To evaluate the clinical effect of progressive flap transfer combined with pedicled flap transfer in the treatment of severe concealed penis in children.Methods:From February 2019 to November 2022,72 patients with severe concealed penis who underwent surgical treatment in the First Affiliated Hospital of Xinxiang Medical University were retrospectively analyzed.Among them,48 cases(observation group)were treated with progressive flap transfer technique combined with pedicled flap transfer technique;24 cases(control group)were treated with Brisson operation.The operation time,average hospital stay,intraoperative blood loss,penis extension length,prepuce edema time,flap infection rate and family satisfaction rate of the two groups were recorded.Results:Both groups of operations were successful except one case of penile retraction in control group.The length of penis extension,prepuce edema time,average hospital stay,operation time and surgical satisfaction score in the observation group were(2.85±0.29)cm,(45.88±3.61)d,(7.75±2.81)d,(73.21±4.89)min,(8.38±0.97)points,significantly better than those in the control group which were(2.43±0.43)cm,(52.38±5.24)d,(9.21±2.08)d,(67.71±4.56)min,(7.50±1.64)points.The comparison between the two groups was statistically significant(t=4.267,-5.464,-2.249,5.598,2.852,all P<0.05).The intraoperative blood loss,the postoperative flap infection rate and satisfaction rate in the observation group were(6.29±1.64)mL,2.1%,and 95.8%,compared with the control group of(6.83±1.90)mL,4.2%,and 83.3%,the difference was not statistically significant(t=-1.253,0.529,1.841,both P>0.05).Conclusion:Progressive flap transfer technique combined with pedicled flap transfer technique can effectively solve the problem of penis skin coverage in children with severe concealed penis.The degree of postoperative edema is lighter,the appearance is more natural and beautiful after surgery,making it especially suitable for severe concealed penis with poor scrotal skin condition.

关 键 词：重度隐匿性阴茎 儿童 带蒂皮瓣转移 渐进皮瓣转移 Brisson术 

分 类 号：R726.1[医药卫生—儿科]