传统包皮环切术和套环环切术在小儿包茎治疗中的比较分析

目的 比较分析传统包皮环切术和套环环切术在治疗小儿包茎中的利弊,为不同包茎患者选择环切术式提供参考.方法 对182例小儿包茎患者随机行包皮传统环切术或套环环切术,统计术前情况、手术时间和术后情况,对所有采集资料进行回顾性分析.结果 术前有粘连的小儿包茎患者术后愈合时间传统环切术（9.14±2.71）d]较套环环切术（13.01±3.12）d]更短（P＜0.05）,无粘连患者两种手术方式愈合时间差异无统计学意义（P＞0.05）;手术时间套环环切（6±1.8）min]较传统环切（15±2.5）min]明显缩短（P＜0.01）;术后伤口裂开渗血、粘连及水肿等并发症的发生率套环环切术较传统环切术更低（P＜0.05）;术后疼痛持续时间传统环切术较套环环切术更短（P＜0.05）.结论 两种手术方式均为小儿包茎患者的有效治疗方法,套环环切术因手术时间短、操作简单、术后并发症少和切口美观的优点可作为首选治疗方式,但术前有粘连的小儿包茎患者更推荐行传统环切术.

Comparative analysis of conventional circumcision versus plastibell circumcision for pediatric phimosis

Objective To compare the advantages and disadvantages of conventional and plasti- bell circumcision for pediatric phimosis and provide references for selecting suitable methods in different patients. Methods A total of 182 pediatric patients with phimosis were randomly assigned to accept conventional circumcision or plastibell circumcision. The collected data of preoperative situation, operation time and postoperative situation were retrospectively analysed. Results For patients with adhesion, the postoperative healing time in conventional group was shorter than that in plastibe11 circumcision group （9.14 ＋ 2.71 vs. 13.01 ＋ 3.12 d,P 〈 0.05 ）. For other patients without adhesion, the difference in post- operative healing time between the groups was not significant. （ P 〉 0.05 ）. The operation time in plastibell circumcision group was significantly shorter than that in the conventional group（ 6 -＋ 1.8 min vs. 13 ＋ 2.5 miu,P 〈 0.01 ）. And plastibell circumcision had a lower incidence rate of postoperative complications, in- cluding hemorrhage, adhesion and edema. The pain duration after operation in the conventional circumci- sion was shorter than that in the plastibell circumcision （ P 〈 0.05 ）. Conclusion Both conventional and plastibell circumcision are effective in treating pediatric phimosis. The plastibell circumcision has the ad- vantages of short operation time, simple operation ,few postoperative complications and a satisfying cosmetic effect,which could be the first-ine therapy in pediatric phimosis. However, conventional circumcision is still recommended for patients with preoperative adhesion.