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目的探讨尿道下裂尿道成形术后尿瘘的处理。方法总结1994~2003年464例尿道下裂尿道成形术后尿瘘治疗的临床经验。年龄1~18岁,平均6.5岁。2/3患儿来自外院。大尿瘘163例使用Thiersch、Snodgrass、Duckett、Duplay、Mathieu、Onlay、Denis-Browne和阴囊中隔修补术。小尿瘘301例用简单切开缝合法和Y-V皮瓣覆盖尿瘘修补法。结果术后随访6个月~10年,一次修补成功率93.3%,其中大瘘85.9%,小瘘97.3%。结论尿道下裂Ⅰ期手术方法的正确选择对提高尿瘘修补手术成功率至关重要。应该按照尿瘘的大小、位置、数量和局部条件选择不同修瘘手术方法。
Objective To investigate the treatment of urinary fistula after hypospadias urethroplasty. Methods The clinical experience of urinary fistula after 466 cases of hypospadia urethroplasty was summarized from 1994 to 2003. Ages 1 to 18 years old, average 6.5 years old. 2/3 children from outside the hospital. 163 cases of urinary fistula using Thiersch, Snodgrass, Duckett, Duplay, Mathieu, Onlay, Denis-Browne and scrotal septal repair. 301 cases of urinary fistula with simple incision suture and Y-V flap to cover the fistula repair method. Results The patients were followed up for 6 months to 10 years. The success rate of primary repair was 93.3%, of which 85.9% were large fistula and 97.3% were small fistula. Conclusions The correct choice of stage Ⅰ hypospadias surgical procedure is very important to improve the success rate of repair surgery of urinary fistula. Urine fistula should be in accordance with the size, location, quantity and local conditions to choose different repair fistula surgery.