摘要
目的分析在应用带血管蒂的皮瓣尿道成形术中,应用血管蒂筋膜覆盖尿道的要点,探讨提高治愈率的措施。方法改进包皮岛状皮瓣及阴囊中隔带蒂皮瓣尿道成形术。在完成常规步骤后,将血管蒂筋膜缝合固定在阴茎白膜及尿道海绵体上,使尿道完全被血管蒂筋膜覆盖,增加了覆盖在尿道表面组织的厚度及血供。对是否使用血管蒂筋膜覆盖病例的Ⅰ期治愈率等效果进行统计学分析。结果与对照组相比,应用血管蒂筋膜覆盖者,包皮岛状皮瓣尿道成形术Ⅰ期治愈率由64.8%提高到93.3%(P<0.01),尿道瘘发生率由24.1%降到1.9%。阴囊中隔皮瓣尿道成形术Ⅰ期治愈率由84.2%提高到95.7%(P<0.01),尿道瘘发生率由7.0%降到1.2%。结论应用血管蒂筋膜覆盖尿道能增加新形成尿道及吻合口的组织覆盖面及厚度,保证良好的血供,是减少尿道下裂术后尿道瘘的一种有效措施。
Objective To review the effectiveness of vascular pedicle in hypospadias urethroplasty. Methods The results of hyposapdias repair using prepuce island flap and serotal dartos flap were revealed. Results The single stage success rate increased from 64. 8% to 93.3% （P〈0. 01）. The incidence of urethroeutaneous fistula decreased from 24. 1% to 1.9%. The success rate of serotal dartos flap urethroplasty with vascular pedicle in onestage hypospadias repair increased from 84. 2% to 95.7%（P〈0. 01 ） and the incidence of urethroeutaneous fistula decreased from 7. 0% to 1.2%. Conclusions Vascular pedicle fascia covering the urethra could minimize urethrocutaneous fistula after hypospadias repair.
出处
《中华小儿外科杂志》
CSCD
北大核心
2005年第10期517-519,共3页
Chinese Journal of Pediatric Surgery
