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目的探讨精准包皮成形及切口黏合技术治疗小儿包茎及包皮过长的方法和效果。方法选择160例包茎及包皮过长患儿,年龄5~14岁,平均年龄8岁。应用内外板分切精准包皮成形手术进行治疗,切口关闭选择组织胶黏合。对照组为148例患儿,年龄6~14岁,平均年龄9岁。采用传统包皮环切术进行治疗。回顾性分析其手术时间、手术过程、恢复过程,术后远近期并发症的发生情况及外观满意率等。结果所有患儿均顺利完成手术。精准包皮成形术组手术时间(25±6)min,术中出血量为(3.05±1.15)m L,术后疼痛轻微,术后24 h疼痛评分2.65±0.85;术后复查均无切口感染,仅3.75%轻度水肿,包皮外观自然,满意率98.75%。对照组手术时间(23±8)min,术中出血量为(8.30±3.60)m L,术后24 h疼痛评分5.60±1.35。术后并发症发生率,精准包皮成形术组均无切口感染,仅3.75%患儿轻度水肿,外观满意率98.75%;对照组切口感染0.68%,系带对合不良0.68%,切口裂开出血0.68%,包皮水肿8.11%,外观满意率93.24%。二者相比,精准包皮成形术较传统包皮环切术手术出血更少,术后疼痛轻微,并发症发生率低,术后外观满意率高(P<0.05),手术时间二者无差异。结论内外板分切精准包皮成形手术结合切口黏合技术治疗小儿包茎及包皮过长效果良好,实用性强。
Objective To investigate the method and effect of precise circumcision and incision adhesion in the treatment of children with phimosis and prepuce. Methods 160 cases of phimosis and prepuce children, aged 5 to 14 years old, with an average age of 8 years old. The application of internal and external cutting board precision foreskin for surgical treatment, incision closure of the choice of tissue adhesive. The control group of 148 children, aged 6 to 14 years, mean age 9 years. The use of traditional circumcision for treatment. Retrospective analysis of the operation time, operation process, recovery process, the incidence of postoperative complications and the appearance of the satisfaction rate. Results All children completed the operation smoothly. The operation time (25 ± 6) min, intraoperative blood loss (3.05 ± 1.15) m L, slight postoperative pain and pain score of 24 h after operation were 2.65 ± 0.85 in the precision circumcision group. No incision infection was found after the operation. Only 3.75% of mild edema, foreskin natural appearance, the satisfaction rate of 98.75%. The operation time of the control group was (23 ± 8) min, the intraoperative blood loss was (8.30 ± 3.60) m L, and the pain score was 5.60 ± 1.35 at 24 h after operation. There was no incision infection in the precision circumcision group, mild edema in only 3.75%, and the appearance satisfaction rate was 98.75%. In the control group, the incidence of incision infection was 0.68%, and the accuracy of laceration was 0.68% Bleeding 0.68%, 8.11% of the foreskin edema, the appearance of satisfaction rate of 93.24%. Compared with conventional circumcision, precision circumcision had less bleeding, less postoperative pain, lower complication rate, higher postoperative appearance satisfaction (P <0.05), and no difference in operative time. Conclusions Precision circumcision and circumcision combined with incision and adhesive technique in the treatment of infantile phimosis and foreskin is effective and practical.