改良袖套式包皮环切术与传统包皮环切术治疗小儿包茎的疗效比较

目的:比较改良袖套式包皮环切术与传统包皮环切术治疗小儿包茎的临床效果,为小儿包茎的治疗寻找一种更为合理的手术方式。方法:选取160例2～7岁的包茎患儿随机分为两组。观察组:80例,采用改良袖套式包皮环切术;对照组:80例,采用传统包皮环切术。改良术式主要包括异丙酚芬太尼复合罗哌卡因局部麻醉、包皮狭窄口背侧松解、包皮内板解剖定位及由内板向外板环形袖套式剥除法,对两组的手术时间、愈合时间、出血量、术后疼痛时间、术后并发症(水肿、血肿及外观差)进行比较。结果:观察组平均手术时间为(25.4±2.3)min,愈合时间为(5.5±1.5)天;对照组平均手术时间为(24.6土5.2)min,愈合时间为(5.8±2.0)天,两组比较差异不显著(均P0.05)。观察组的平均出血量为(1.0土0.6)ml,术后疼痛时间(3±2.4)h;对照组的平均出血量为(4.5±0.8)ml,术后疼痛时间(16±5.8)h,两组比较差异显著(均P0.05)。观察组术后出现血肿、水肿及外观差的并发症明显较对照组减少,两组差异显著(均P0.05)。结论:经改良后的袖套式包皮环切术易于掌握、术后效果良好、并发症少,更适合于小儿包茎的治疗,值得在临床上推广。

Improved sleeve circumcision and traditional circumcision compared the curative effect of treatment of pediatric phimosis

Objective To compare improved sleeve circumcision and traditional circumcision for treatment of pediatric phimosis, thus to seek a more reasonable operation method. Methods One hundred and sixty patients of phimosis were selected and divided into improved sleeve type circumcision group （eighty cases） and circumcision group （eighty cases）,improved operation mainly including propofol fentanyl compound,pp because local anesthesia,wrapping narrow mouth dorsal loose solution,sheath board anatomical location and from the board to the shell plate strip division ring sleevetype,The two groups of operation time,healing time,Amount of bleeding,the duration of post-operative pain and postoperative complications （hematoma,edema,appearance difference） were compared. Results The duration of postoperative pain,amount of bleeding and postoperative compiications （edema, appearance difference） difference had statisticai significance between the two groups （P〈O.05）, but the operation time and healing time,was not statisticaiiy significant difference （P〉0.05）. Conclusion The modified sleeve type circumcision is easy to grasp, have good postoperative effect, less complications, better without the treatment of phimosis, it is a kind of safe and effective method.