分期管形包皮岛状皮瓣在小儿重度尿道下裂手术中的应用价值

目的探讨分期管形包皮岛状皮瓣在小儿重度尿道下裂手术中的应用价值。方法选取2015年5月至2017年5月在本院收治的146例重度尿道下裂患儿,以随机数表法分为观察组与对照组,各73例。观察组行分期管形包皮岛状皮瓣术式治疗,对照组行分期尿道板重建卷管术式治疗,均行2年随访。对比两组围手术期相关临床指标(手术时间、出血量、下床活动时间、住院时间)、临床疗效及并发症发生情况。结果观察组临床疗效总有效率[89.04%(65/73)]显著高于对照组[75.34%(55/73)],差异有统计学意义(P<0.05)。两组手术时间比较,差异无统计学意义[(71.54±15.74)min vs.(71.62±15.70)min,P>0.05];观察组出血量、下床活动时间、住院时间分别为[(13.35±5.24)mL、(1.65±0.77)d、(11.54±3.44)d],显著少于对照组[(16.18±7.30)mL、(2.81±1.01)d、(15.58±5.09)d,P<0.05]。观察组术后并发症总发生率[5.48%(4/73)]显著低于对照组[17.81%(13/73)],差异有统计学意义(P<0.05)。结论分期管形包皮岛状皮瓣术式用于重度尿道下裂患儿的治疗,临床效果满意,患儿术后恢复快,并发症发生率低,具有较高的临床应用价值。

Value of staging tubular prepuce island flaps for severe hypospadias in children

Objective To study the application value of staging tubular prepuce island flaps in the operation of severe hypospadias in children.Methods A total of 146 children with severe hypospadias admitted to our hospital from May 2015 to May 2017 were selected as the subjects,and randomly divided into observation group and control group with 73 cases in each group.The observation group was treated by staged tubular prepuce island flaps,while the control group was treated by staged urethral plate reconstruction and tube rolling.The two groups were followed up for 2 years.The perioperative c linical indicators(operation time,bleeding volume time to get out of bed,hospital stay)were compared between the two groups.The clinical efficacy and complications of the two groups were compared.Results The total effective rate of the obsenation group was 89.04%,which was significantly higher than that of the control group(75.34%,P<0.05).There was no significant difference in operation time between the two groups[(71.54±15.74)min vs.(71.62±15.70)min,P>0.05].The amount of bleeding,the time of getting out of bed and the time of hospitalization in the observation group w ere[(13.35±5.24)mL,(1.65±0.77)d,(11.54±3.44)d],significantly less than those in the control group[(16.18±7.30)mL,(2.81±1.01)d,(15.58±5.09)d,P<0.05].The total incidence of complications in the observation group was 5.48%,which was significantly lower than that in the control group(17.81%,P<0.05).Conclusions Staged tubular prepuce island flaps are used in the treatment of severe hypospadias.The clinical effect is satisfactory.The children recover quickly after operation and the incidence of complications is low.It has high clinical application value.