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目的:探讨保留尿道板纵切卷管尿道成形术(TIP术)在伴有解剖不良因素的尿道下裂Ⅰ期成形术中的应用效果。方法:回顾性分析尿道下裂TIP术式Ⅰ期成形191例,将尿道开口位置、阴茎头及尿道板发育状况、阴茎下曲程度视为易导致TIP术后并发症及影响外观的解剖不良因素,采用SPSS 10.0统计数据,对其临床效果进行相关性分析。结果:①TIP术后并发症发生率与尿道开口位置密切相关,尿道开口越近,并发症发生率越高(χ2=24.291,P<0.01);②TIP术后并发症发生率与阴茎头及尿道板发育状况、阴茎下曲程度密切相关。伴有解剖不良因素的尿道下裂如小阴茎头型、尿道板发育不良型及伴有重度阴茎下曲型,采用TIP术后并发症发生率高于阴茎挺直、阴茎头及尿道板发育良好的尿道下裂(χ2=25.419,P<0.01)。结论:TIP术式的选择应根据尿道下裂类型、阴茎头及尿道板发育状况、阴茎下曲程度并结合术者经验来应用,以期达到成功率高并外形美观的效果。
Objective: To investigate the effect of TIP on the phase Ⅰ hypospadias with anatomical defects. Methods: A retrospective analysis of 191 cases of stage I hypospadias TIP was performed. The location of the urethra, the development of the penis head and urethral plate, the degree of penile subduction were considered as the anatomical factors that could lead to postoperative complications and the appearance of TIP , Using SPSS 10.0 statistical data, the clinical effect of correlation analysis. Results: ①The incidence of postoperative complications was closely related to the location of urethral opening. The closer the urethral opening was, the higher the complication rate was (χ2 = 24.291, P <0.01). ② The incidence of postoperative complications was related to glans penis and urethral plate Development status, the degree of penile curvature is closely related. Hypospadias associated with anatomical factors such as small penis head type, urethral dysplasia and severe penile curvature, the use of TIP postoperative complications higher than the penis straight, penile head and urethral well developed Of hypospadias (χ2 = 25.419, P <0.01). Conclusion: The choice of TIP procedure should be based on the type of hypospadias, glaucoma and urethral plate development, the degree of penile curvature and combined with the experience of the surgeon to achieve high success rate and aesthetic appearance.