包皮环切术中成人包皮环切器内环内置与外置的比较

目的对比分析包皮环切术中环切器内环内置与内环外置的疗效和手术并发症。方法选择2011年4月至2012年4月间在我院就诊的包皮过长患者1211例作为研究对象，入选内环内置组（598例），内环外置组（613例），结合完整的随访数据，对比分析两组在手术时间、术中及术后3d疼痛程度、术中出血量、术后并发症发生率、包皮创口愈合时间、术后1个月外观满意率、总体费用以及术后性交时满意率、术后包皮水肿恢复时间方面的差异。结果在患者术中及术后3d疼痛程度、术后并发症发生率、包皮创口愈合时间方面，内环内置组均优于内环外置组。而对于手术时间、术中出血量、总体费用方面，两组之间无统计学差异。术后随访发现，两组在术后1个月外观满意率、术后1个月外观满意率、性交时满意度、包皮水肿恢复时间方面无统计学差异。结论内环内置法在保持常规操作方式优点的同时，更加有利于包皮创口的愈合、降低并发症和疼痛程度，是对成人包皮环切手术方式的改良，值得在临床上推广。

A comparative study of inner installation and outer installation of inner ring of circumcision suture device

Objoetivo To compare the clinical value and complications of inner installation and outer installation of inner ring of circumcision suture device. Methods 1211 cases who would undergo circumcision suture device were enrolled into inner installation group and outer installation group from April 2011 to April 2012. Comparisons were made between the two groups on operation time, intraoperative and postoperative pain score, blood loss, postoperative complications, wound healing time, postoperative satisfaction with penile appearance, treatment costs and postoperative satisfaction during copulation and time of preputial edema. Complete follow-up data were analyzed. Rosults Inner installation outweighed outer installation in intraoperative and postoperative pain score, postoperative complications and wound healing time. There was no significant difference in operation time, blood loss, postoperative satisfaction with penile appearance and treatment costs. Follow-up data found that, no significant difference was found between the two groups in postoperative satisfaction with penile appearance postoperative satisfaction during copulation and time of preputial edema. Conclusion Besides the routine advantages of circumcision suture device, inner installation of inner ring is an improved process with shorter healing time and less complication and pain, and is worth promoting clinically.