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目的探讨游离包皮内板一期尿道成形术治疗小儿尿道下裂的临床效果。方法选取2013年1月至2016年1月尿道下裂患儿104例,均采用游离包皮内板一期尿道成形术。术后随访6~22个月,分析手术指标及术后并发症。结果在104例尿道下裂患儿中,成功完成一期尿道成形术89例(85.58%),重建尿道长度(3.5±0.8)cm,手术时间(150.3±45.7)min,住院时间(15.6±4.3)d;术后随访(10.6±2.5)个月,并发症发生率为23.08%(24/104),其中尿瘘12例,尿道狭窄6例,创面感染4例,皮肤缺血坏死2例。术后阴茎显露不良6例,其他患儿阴茎外观良好,伸直满意。手术前后HOSE、VAS评分比较差异有统计学意义(P<0.05)。结论游离包皮内板一期尿道成形术治疗小儿尿道下裂效果显著,并发症少,尿道外观良好。
Objective To investigate the clinical effect of the first stage urethroplasty of the free foreskin plate in the treatment of hypospadias in children. Methods A total of 104 children with hypospadias from January 2013 to January 2016 were enrolled in this study. All of them were treated with the first stage urethroplasty of free foreskin. The patients were followed up for 6 to 22 months and the surgical indexes and postoperative complications were analyzed. Results In the 104 cases of hypospadias, 89 cases (85.58%) of urethroplasty were successfully completed, the urethral length (3.5 ± 0.8) cm, the operation time (150.3 ± 45.7) min, the hospitalization time (15.6 ± 4.3 ) d. The postoperative follow-up was (10.6 ± 2.5) months. The complication rate was 23.08% (24/104). There were 12 cases of urinary fistula, 6 cases of urethral stricture, 4 cases of wound infection and 2 cases of skin necrosis. Postoperative penis revealed poor in 6 cases, other children with good appearance of the penis, straight satisfaction. The HOSE and VAS scores before and after surgery were significantly different (P <0.05). Conclusions The first stage urethroplasty of the free foreskin plate is effective in treating pediatric hypospadias with few complications and a good appearance of the urethra.