含硅胶垫圈的一次性包皮环切吻合器行儿童包皮环切术后包皮水肿的原因探讨  

Discussion on the causes of preputial edema and improvement of surgical methods after child circumcision with disposable circumcision stapler containing silicone gasket

作　　者：赵友 罗卫平[1] 聂军[1] 李子昊 Zhao You;Luo Weiping;Nie Jun;Li Zihao(Department of Urology,Liyang People′s Hospital,Liyang 213300,China)

机构地区：[1]溧阳市人民医院泌尿外科,溧阳213300

出　　处：《国际泌尿系统杂志》2024年第4期674-677,共4页International Journal of Urology and Nephrology

基　　金：溧阳市人民医院(江苏省人民医院溧阳分院)2023年度院级课题项目(2023YJKT0011)。

摘　　要：目的探讨含硅胶垫圈的一次性包皮环切吻合器行儿童包皮环切术后引起包皮水肿的原因和手术改良的方法。方法回顾性分析2020年1月至2022年10月在本院泌尿外科收治的340例包皮环切术患儿的临床资料,其中170例患儿采用改良含硅胶垫圈的一次性包皮环切吻合器术式(研究组),170例患儿采用常规含硅胶垫圈的一次性包皮环切吻合器术式(对照组)。对比两组患儿的手术时间、术后水肿、出血、切口裂开和吻合钉残留发生情况。结果研究组和对照组的手术时间[(10.56±2.00)min vs.(10.37±1.72)min]、术后出血发生率[2.4%(4/170)vs.3.5%(6/170)]、切口裂开发生率[0.6%(1/170)vs.1.2%(2/170)]及吻合钉残留发生率[1.2%(2/170)vs.1.8%(3/170)]比较,差异均无统计学意义(均P>0.05)。研究组的术后水肿发生率低于对照组[0.6%(1/170)vs.10.6%(18/170),P<0.05]。结论含硅胶垫圈的一次性包皮环切吻合器行儿童包皮环切术造成包皮水肿的主要原因是由硅胶垫圈呈环行挤压切口导致包皮血液及淋巴循环障碍引起。术中将硅胶垫圈在呈"*"形位置处剪开能够显著减少术后包皮水肿的发生,是一种安全可靠的方法,在临床上具有一定的推广价值。Objective To investigate the causes of prepuce edema caused by disposable circumcision with silicone gasket stapler in children and to improve the surgical methods.Methods The clinical data of 340 children with disposable circumcision stapler containing silicone gasket were retrospectively analyzed in our hospital from January 2020 to October 2022.Among them,study group were treated with modified disposable circumcision stapler containing silicone gasket,and control group were performed with conventional disposable circumcision stapler containing silicone gasket,with 170 cases in each group.The operation time,postoperative edema,bleeding,incision dehiscence and anastomotic nail residue were compared between the two groups.Results There was no significant difference between the study group and the control group in the operation time[(10.56±2.00)min vs.(10.37±1.72)min],the incidence of postoperative bleeding[2.4%(4/170)vs.3.5%(6/170)],the incidence of incision dehiscence[0.6%(1/170)vs.1.2%(2/170)],and the incidence of anastomotic nail residue[1.2%(2/170)vs.1.8%(3/170)](all P>0.05).There was a statistically significant difference between the study group and the control group in the incidence of postoperative edema[0.6%(1/170)vs.10.6%(18/170),P<0.05].Conclusions The main reason for the prepuce edema caused by the silicone gasket compression incision is the obstruction of the blood and lymphatic circulation of the prepuce.Cutting the silicone gasket at the position of"*"during surgery can significantly reduce the occurrence of postoperative prepuce edema,which is a safe and reliable method and has certain promotion value in clinical practice.

关 键 词：包皮环切术 男性 儿童 水肿 一次性包皮环切吻合器 

分 类 号：R726.9[医药卫生—儿科]