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目的:总结Snodgrass、Duckett、膀胱粘膜尿道成形3种常用术式治疗中、后段尿道下裂的经验和体会,为临床术式选择提供参考。方法:对1997年至2008年间251例施行Snodgrass、Duckett、膀胱粘膜成形3种术式的中、后段尿道下裂进行回顾性分析。结果:3种术式在中段尿道下裂中成功率分别为80.3%(53/66)、76.0%(19/25)和78.9%(15/19),无明显统计学差异(P均>0.05);后段尿道下裂分别为70.0%(42/60)、63.6%(14/22)和88.1%(52/59),膀胱粘膜尿道成形在后段尿道下裂修补的成功率明显高于Snodgrass式和Duckett式(P<0.05);Ⅱ期手术中,采用膀胱粘膜修补的成功率也明显高于Snodgrass和Duckett术式(P<0.05);<14岁的患儿采用Duckett术式的成功率明显高于≥14岁的患者(P<0.05)。结论:在3种术式中,游离膀胱黏膜成形术更适合于后段尿道下裂患者,<14岁的患儿推荐采用Duckett术式。
OBJECTIVE: To summarize the experiences and experiences of three commonly used procedures for the treatment of mid and posterior hypospadias, such as Snodgrass, Duckett and bladder mucosa and urethroplasty, and to provide a reference for clinical choice. Methods: Retrospective analysis was performed on 251 cases of middle and posterior hypospadias in 251 cases who performed Snodgrass, Duckett and bladder mucosa formation between 1997 and 2008. Results: The successful rates of the three surgical procedures in the middle stage of hypospadias were 80.3% (53/66), 76.0% (19/25) and 78.9% (15/19) respectively, with no significant difference (all P> 0.05 ); Posterior segment hypospadias were 70.0% (42/60), 63.6% (14/22) and 88.1% (52/59), respectively. The success rate of bladder mucosal urethroplasty in the repair of posterior urethral dissection was significantly higher Snodgrass-type and Duckett-type (P <0.05). The success rate of bladder mucosal repair in stage II surgery was also significantly higher than that of Snodgrass and Duckett procedures (P <0.05) The rates were significantly higher than those of ≥14 years (P <0.05). CONCLUSIONS: In three surgical procedures, free bladder mucosa was more suitable for posterior segment hypospadias, and Duckett was recommended for children <14 years of age.