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目的:比较单纯包皮环切与阴茎脱套固定术治疗成年肥胖患者包皮过长或包茎的疗效。方法:44例包皮过长或包茎合并超重或肥胖患者根据术前患者及家属意愿,分为单纯包皮环切组24例和阴茎脱套固定组20例,年龄分别为(26.38±4.24)岁和(26.90±3.14)岁,BMI指数分别为(27.77±0.77)kg/m~2和(28.07±2.28)kg/m~2,阴茎体显露长度分别为(3.51±0.46)cm和(3.50±0.59)cm,以利多卡因联合甲磺酸罗哌卡因局麻下分别行包皮环切术和阴茎脱套固定术。结果:包皮环切组手术时间(28.04±2.65)min。脱套固定组手术时间(45.45±3.49)min。术后1、6个月随访,两组患者勃起功能均正常,无严重并发症发生,术后6个月阴茎体显露长度包皮环切组(3.70±0.47)cm,脱套固定组(5.01±0.73)cm,术后6个月患者满意度包皮环切组(2.83±0.56)分,脱套固定组(3.25±0.71)分,阴茎脱套固定组患者术后6个月阴茎体显露长度及阴茎外形满意度更高,差异具有统计学意义。结论:阴茎脱套固定术治疗成年肥胖包皮过长或包茎效果满意,术后阴茎外观理想。以利多卡因联合甲磺酸罗哌卡因阴茎根部阻滞麻醉,局部麻醉效果良好,可作为成人阴茎脱套固定术的麻醉选择。
OBJECTIVE: To compare the curative effect of prepuce circumcision and penile decapsulation in the treatment of overgrowth or phimosis in adult obese patients. Methods: Forty - four patients with overgrown or phimosis who were overweight or obese were divided into two groups according to the preoperative patients ’and their family members’ wishes: 24 cases of simple circumcision and 20 cases of penile removal and fixation group, with the age of (26.38 ± 4.24) years and (26.90 ± 3.14) years old, the BMI index was (27.77 ± 0.77) kg / m 2 and (28.07 ± 2.28) kg / m 2 respectively, and the length of the penis was 3.51 ± 0.46 cm and 3.50 ± 0.59 ) cm, with lidocaine combined with ropivacaine mesylate under local anesthesia circumcision and penile detachment fixation. Results: The operation time of circumcision group (28.04 ± 2.65) min. The operation time of the decorticating group (45.45 ± 3.49) min. The patients were followed up for 1 and 6 months after operation. The erectile function of both groups were normal and no serious complication occurred. The penis showed the length of 3.70 ± 0.47 cm at 6 months after operation, 0.73) cm, and the satisfaction degree of the circumcision group (2.83 ± 0.56) and detachment fixation group (3.25 ± 0.71) at 6 months after operation, and the penis body exposed length at 6 months after operation Penis shape satisfaction higher, the difference was statistically significant. Conclusion: The treatment of penile decapsulation fixation for the treatment of adult obese prepuce or phimosis results satisfactory postoperative penile appearance ideal. Lidocaine combined with ropivacaine mesylate penile root block anesthesia, local anesthesia with good results, can be used as adult anesthesia for the removal of the penis fixation.