论文部分内容阅读
目的 :总结过去 15年尿道下裂外科诊治经验 ,进一步提高其治疗水平。方法 :对过去 15年收治的2 72例尿道下裂患者临床资料进行回顾性研究。 2 72例患者年龄 1.5～ 2 7岁 ,平均 10 .13岁 ,其中阴茎头冠状沟型4 7例 (17.2 8% ) ,阴茎体型 12 0例 (44 .12 % ) ,阴茎阴囊型 88例 (32 .35 % ) ,会阴型 17例 (6 .2 5 % )。手术方式主要为皮条埋藏法 (Denisbrowne术 )、膀胱粘膜代尿道法、横裁包皮岛状皮瓣尿道成形术 (Duckett术 )及阴囊中缝岛状皮瓣尿道成形术等。结果 :一次手术成功率由 1987～ 1991年的 39.3%升高到 1992～ 1996年的 6 0 .4 % ,近 5年来 (1997～ 2 0 0 1年 )达到 76 .4 % ;尿瘘发生率由 1987～ 1991年的 4 5 .9%减少到 1992～ 1996年的 2 9.7% ,近 5年来再减少到 16 .4 % ,其他并发症也相应减少。结论 :随着手术方式的改进 ,外科技术水平及缝线质量的提高 ,尿道下裂一次手术成功率逐年上升 ,并发症逐年下降。如果指定专人手术 ,加强术后护理 ,可望进一步提高手术成功率
OBJECTIVE: To summarize the experience of diagnosis and treatment of hypospadias in the past 15 years and further improve the treatment level. Methods: The clinical data of 2 72 cases of hypospadias treated in the past 15 years were retrospectively studied. 2 72 patients were 1.5 to 27 years old with an average of 10.13 years old, of which 47 cases (17.28%) had coronal glaucoma, 120 cases (44.12%) had penis scrotum, 88 cases 32.35%), 17 cases of perineal (6.52%). The main surgical methods are the burial method (Denisbrowne technique), the bladder mucosa-urethra method, the transverse cutaneous island flap urethroplasty (Duckett’s operation), and the scrotal island flap flap urethroplasty. Results: The success rate of one operation increased from 39.3% in 1987 ~ 1991 to 60.4% in 1992 ~ 1996, and reached 76.4% in the past 5 years (1997 ~ 2001). The incidence of urinary fistula was From 1987 to 1991, 45.9% was reduced from 2 9.7% in 1992-1996 to 16.4% in the last 5 years, and other complications were also reduced accordingly. Conclusion: With the improvement of surgical methods, surgical techniques and the improvement of suture quality, the success rate of one operation of hypospadias rises year by year and the complication decreases year by year. If the appointment of special surgery to enhance postoperative care, is expected to further improve the success rate of surgery