CO_2激光包皮环切术的时机和手术方法探讨

目的明确CO2激光包皮环切术的手术最佳年龄段和探讨分层手术的优点。方法对2981例患者手术配合、手术中出血、手术后并发症的情况进行比较,分析手术时机的选择;通过分组对比手术后并发症情况,分析手术方法的选择;通过手术后休息情况,观察对并发症的影响。结果随着年龄增大,手术配合率增高;6岁以上较6岁以下手术出血的可能性增大,且18岁以上患者出血量增加;18岁以上较18岁以下水肿情况重;随年龄增大,术后出血、瘀斑、血肿情况有加重趋势;14岁以上较14岁以下术后10天感染率高;18岁以上,术后15天伤口裂开比例较大;各项数据显示分层包皮环切的治疗组明显优于内外板同时环切的对照组;术后平卧时间越长并发症发生的可能性越小。结论手术时间应选择7-13岁为宜,11-13岁为行包皮环切术的黄金时期;分层包皮环切优于内外板同时环切的手术方法;充分的休息有利于减少并发症。

Choice of Operation Occasions and Surgical Method of CO2 Laser Circumcision

Objective To identify the best range of ages for CO2 laser circumcision and discuss the advantages of layered surgery. Methods The surgery timing was analyzed by comparing 2 981 patients in cooperation and bleeding during surgery and occurrence of post-surgical complications; the selection of surgical methods was discussed by comparing the patients in different groups as to post-sur- gical complications; and the impact of post-surgical rest on the complications was observed. Results The cooperation during operation improved with the growth of the age. Bleeding occurred more often to 6 years or older pa- tients than those below 6 years old. The amount of bleeding grew for the patients over the age of 18. Hydroneus was more serious under the age of 18 than over it. Bleeding, bruises and haematoma became more and more serious with the growth of the age. The infection rate of the 10th day after the operation was lower for patients under 14 than over 18. The postoperative 15 days wound split proportion increased from the age of 18. The results of the treatment group of layered circumcision were better obviously than the control group of simultaneous internal and external supracrestal fibrotomy. The longer the post-operative rest, the less the potential complications. Conclusions The circumcision should be done at the age from 7 to 13, and the best range is from 11 to 13 years old. Layered circum- cision is better than simultaneous internal and external board supracrestal fibrotomy. Sufficient rest helps reducing the complications.