应用一次性包皮环切吻合器(商环)与经典式、袖套式包皮环切术的临床对比研究

目的比较商环式、经典式、袖套式3种包皮环切术的优缺点。方法 2009年7月～2011年10月,按就诊时间结合患者意愿分为3组,行包皮背侧切开包皮环切术107例(经典组),袖套式包皮环切术116例(袖套组),应用一次性包皮环切吻合器(商环)行包皮环切术119例(商环组)。对比3组手术时间、疼痛评分、失血量、伤口愈合时间、手术并发症发生率、术后包皮外观满意率、治疗费用等。结果与经典组及袖套组相比,商环组手术时间短(27.5±5.6)min vs.(36.0±4.4)min vs.(4.5±0.9)min,F=1889.000,P=0.000],出血量少(12.7±6.1)ml vs.(3.7±1.6)ml vs.(0.6±0.1)ml,F=354.031,P=0.000],术后24 h疼痛评分低(5.5±1.3)分vs.(5.2±1.2)分vs.(1.6±0.9)分,F=404.029,P=0.000],术后包皮外观满意率高87.9%(94/107)vs.92.2%(107/116)vs.99.2%(118/119),χ2=11.786,P=0.003],但拆环(线)的疼痛评分高(3.2±1.5)分vs.(3.0±1.8)分vs.(8.7±1.0)分,F=557.214,P=0.000],伤口愈合时间长(13.9±2.0)d vs.(12.1±2.6)d vs.(23.6±4.8)d,F=392.169,P=0.000],治疗费用高(310.4±15.3)元vs.(332.2±13.8)元vs.(882.0±8.2)元,F=75 540.000,P=0.000],3组手术并发症发生率差异无显著性13.1%(14/107)vs.10.3%(12/116)vs.7.6%(9/119),χ2=1.872,P=0.392]。结论 3种包皮环切术各有优缺点,商环式操作方法简单,手术时间短,出血量少,包皮外观满意度高,但拆环时疼痛明显,伤口愈合时间长,费用较高。

Comparison of Disposable Circumcision Stapler with Conventional,and Sleeve Circumcision

Objective To compare the advantage and disadvantage of disposable circumcision stapler(Shang Ring),conventional circumcision,and sleeve circumcision.Methods From July 2009 to October 2011,according to the wishes of patients,people who were receiving circumcision in our hospital were divided into three groups: conventional,sleeve,and Shang Ring groups(n=107,116 and 119,respectively).The operation time,pain score,blood loss,wound healing time,rate of postoperative complications,postoperative satisfaction with penile appearance,and treatment cost were compared among the groups.ResultsShang Ring group showed significantly shorter operation time (27.5±5.6) min vs.(36.0±4.4) min and(4.5±0.9) min,F=1889.000,P=0.000],less blood loss (12.7±6.1) ml vs.(3.7±1.6) ml and(0.6±0.1) ml,F=354.031,P=0.000],lower pain score in 24 hours(5.5±1.3 vs.5.2±1.2 and 1.6±0.9,F=404.029,P=0.000),higher rate of postoperative satisfaction with penile appearance 87.9%(94/107) vs.92.2%(107/116) and 99.2%(118/119),χ2=11.786,P=0.003],but higher pain score when removing the ring(3.2±1.5 vs.3.0±1.8 and 8.7±1.0,F=557.214,P=0.000),longer wound healing time (13.9±2.0) d vs.(12.1±2.6) d and(23.6±4.8)d,F=392.169,P=0.000],and higher treatment cost (310.4±15.3) RMB vs.(332.2±13.8) RMB and(882.0±8.2) RMB,F=75 540.000,P=0.000] than the conventional and sleeve groups.No significant difference existed in the rate of postoperative complications among the three groups 13.1%(14/107) vs.10.3%(12/116) and 7.6%(9/119),χ2=1.872,P=0.392].Conclusions All the approaches have advantages and disadvantages.The Shang Ring circumcision is the simplest with short operation time,few blood loss,and satisfied postoperative appearance of the penile,however,the pain of removing the ring is significant,the wound healing time is long,and the cost is high.