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目的:观察血栓通静脉滴注加双层皮内缝合法治疗小儿尿道下裂重建术后尿瘘的临床疗效。方法:将符合病例入选标准的90例尿道下裂术后尿瘘患儿随机分为观察组、对照组各45例。两组均给予清洁换药,观察组加用血栓通注射液4 mL+生理盐水250 mL,静脉滴注,2次/d,连续使用14 d。结果:观察组修复成功40例,成功率达88.89%;对照组修复成功32例,成功率为71.11%。两组相比差异显著(P<0.05)。创口甲级愈合率观察组为88.89%,对照组为71.11%,两组差异显著(P<0.05)。观察组住院时间、尿瘘愈合时间短于对照组,两组差异显著(P<0.05);再次发生尿瘘率观察组为2.22%,对照组为11.11%,两组差异显著(P<0.05)。血液流变学指标两组治疗后明显降低(P<0.05);治疗组改善优于对照组(P<0.05)。结论:血栓通静脉滴注加血管缝线双层皮内缝合法治疗小儿尿道下裂重建术后尿瘘成功率高,创口愈合好,住院时间、尿瘘愈合时间短,再次发生尿瘘率低。
Objective: To observe the clinical effect of thrombosis and intravenous drip plus double skin suture in the treatment of urinary fistula after reconstruction of pediatric hypospadias. Methods: Ninety cases of urinary fistula who were treated with hypospadias were randomly divided into observation group and control group with 45 cases each. The two groups were given clean dressing, the observation group plus Xueshuantong injection 4 mL + saline 250 mL, intravenous infusion, 2 times / d, continuous use 14 d. Results: In the observation group, 40 cases were successfully repaired, the success rate was 88.89%. In the control group, 32 cases were repaired successfully with a success rate of 71.11%. There was significant difference between the two groups (P <0.05). The rate of wound healing in grade A was 88.89% in the observation group and 71.11% in the control group, with significant difference between the two groups (P <0.05). The hospitalization time of the observation group was shorter than that of the control group, and the difference was significant (P <0.05). The recurrence rate of urinary fistula was 2.22% in the observation group and 11.11% in the control group (P <0.05). The indexes of hemorheology were significantly lower in both groups after treatment (P <0.05); the treatment group improved better than the control group (P <0.05). Conclusion: The success rate of urinary fistula after thrombus and intravenous drip plus vascular suture double-layer intradermal suture in pediatric children with hypospadias reconstruction is high, wound healing is good, hospitalization time is short, and the rate of urinary fistula is low again.