改良尿道板纵切卷管法在治疗小儿尿道下裂中应用价值分析.docVIP

改良尿道板纵切卷管法在治疗小儿尿道下裂中应用价值分析 　　[摘要]目的 探?改良尿道板纵切卷管法在治疗小儿尿道下裂中的应用价值。方法 选取2014年3月～2016年3月在我院外科治疗的82例小儿尿道下裂患儿作为研究对象，按照随机数字表法将其分为两组，每组各41例。对照组患者采用传统手术方法治疗，观察组患者采用改良尿道板纵切卷管法治疗。比较两组患者的治疗效果、并发症发生情况，记录观察组患儿的术后尿瘘发生率。结果 术后随访6～15个月，观察组患者的治疗总有效率为97.56%，明显高于对照组的85.37%，差异有统计学意义（P0.05），患儿阴茎形状正常，尿道开口正位，排尿通畅，阴茎无弯曲。术后，观察组患者尿瘘、尿道狭窄、感染等并发症发生率明显低于对照组，差异有统计学意义（P0.05）。观察组患儿的阴茎阴囊型的尿瘘发生率最高，其次为阴茎体型，冠状沟型未发生尿瘘，阴茎体型、冠状沟型和阴茎阴囊型术后尿瘘的发生率比较，差异有统计学意义（P0.05）。尿瘘者行尿瘘修补术后痊愈，尿道狭窄者经尿道扩张术后痊愈。结论 改良尿道板纵切卷管法在治疗小儿尿道下裂中有良好的应用价值，能提高一次手术成功率，降低术后并发症和二次手术的概率，且能加快患儿术后恢复，具有积极的临床意义。 　　[关键词]小儿尿道下裂；改良尿道板纵切卷管法；应用价值 　　[中图分类号] R726.9 [文献标识码] A [文章编号] 1674-4721（2018）2（a）-0119-04 　　[Abstract]Objective To investigate the application value of modified tubularized incised plate （TIP） urethroplasty in the treatment of hypospadias in children.Methods Altogether 82 cases of pediatric hypospadias who accepted surgical treatment in our hospital from March 2014 to March 2016 were selected as subjects and were randomly divided into two groups according to the random number table method，41 cases in each group.The traditional surgical method was used in the control group；while，the observation group were treated with modified TIP urethroplasty.The surgical effectiveness and complications of patients between two groups were compared，the incidence of postoperative urinary fistula was recorded in the observation group.Results The total effective rate of patients in the observation group of postoperative follow-up 6-15 months was 97.56%，which was significantly higher than the 85.37% in the control group，and the difference was statistically significant （P 　　[Key words]Children hypospadias；Modified tubularized incised plate；Application value 　　小儿尿道下裂是常见的小儿泌尿系统生殖器畸形，其发病机制复杂，解剖结构呈现尿道异位开口于尿道腹侧，且阴茎下曲有不同程度畸形。该疾病采用手术治疗是唯一的治愈办法，由于患儿多无法站立解尿，容易引发心理问题，因此临床多主张早期手术，尽早修复阴茎外形，恢复正常排尿功能，?p少对成年后性生活能力的影响[1]。但临床无标准术式，可采用的术式较多，且各有利弊，最常见的问题是术后容易发生尿瘘，是临床手术的一大难题。尿道板纵切卷管尿道成形术（tubularized incised plate，TIP）是近年来较为提倡的一种术式，具有操作简单、术后阴茎外观满意、并发症少等优点[2]。本研究选取在我院外科治疗的82例小