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目的:探讨应用转移口腔粘膜治疗尿道下裂的适应证及手术疗效。方法:尿道下裂患者19例,其中,阴茎根型10例,阴囊型7例,会阴型2例。8例接受过1次尿道成形术,6例接受过两次尿道成形术,5例为第一次尿道手术,7例合并阴茎下弯。14例患者取下唇粘膜,5例取口腔颊粘膜。15例使用加盖口腔粘膜尿道成形,背侧皮肤浅筋膜瓣覆盖新尿道。4例使用口腔粘膜代替尿道板使阴茎伸直,半年后二期行尿道板卷管尿道成形。结果:19例手术患者中,15例加盖口腔粘膜法13例成功,二期尿道板卷管尿道成形4例均成功,手术成功率89.5%(17/19)。阴茎外观满意,尿道开口于阴茎头部前端,经随访3～18个月,无尿道狭窄、尿瘘等并发症。2例术后出现阴茎切口感染而出现尿瘘,半年后再次行补瘘手术后治愈。19例均无口腔创面的并发症。结论:转移口腔粘膜治疗多次手术失败、局部组织缺乏的尿道下裂是一种手术成功率较高的手术方式,值得推广应用。
Objective: To explore the application of the transfer of oral mucosa indications and surgical treatment of hypospadias. Methods: 19 cases of hypospadias, including 10 cases of penis root type, 7 cases of scrotum, 2 cases of perineal. Eight patients underwent one urethroplasty, six underwent urethroplasty, five underwent the first urethral procedure, and seven underwent penile curvature. Twenty-four patients underwent removal of the oral mucosa and five of the oral buccal mucosa. Fifteen cases were stamped with oral mucosa urethroplasty and the superficial urethra was covered with superficial fascia flap of the dorsal skin. 4 cases of oral mucosa instead of urethral plate so that the penis straight, six months after the two urethral plate coil urethra. Results: Of the 19 surgeries, 15 cases were successfully treated with oral mucosa and 13 cases were successful in urethral plaque formation. The successful rate was 89.5% (17/19). Penile appearance satisfaction, urethral opening in the front of the penis head, after 3 to 18 months of follow-up, no urethral stricture, urinary fistula and other complications. 2 cases of penile incision infection occurred after the emergence of urinary fistula, six months after fistula surgery cured again. None of the 19 patients had oral wound complications. CONCLUSION: Multiple oral mucosal metastases failed in the treatment of multiple surgical procedures. Lack of local tissue hypospadias is a surgical method with high success rate. It is worth popularizing and applying.