摘要
目的探讨不同术式对445例不同类型先天性尿道下裂患儿的手术治疗效果。方法回顾性分析我院1988年～2003年445例先天性尿道下裂病例资料,其中采用阴茎阴囊纵隔带蒂皮瓣尿道成型术311例,包皮内板带蒂皮瓣尿道成型术52例,包皮及阴茎阴囊联合皮瓣尿道成型术61例,膀胱粘膜代尿道术21例。每例均同时行耻骨上膀胱造瘘术。结果治愈率90.6%熏并发症为9.4%。其中尿道狭窄11例熏尿瘘31例。尿道狭窄中膀胱粘膜法1例,包皮内板法2例,阴茎阴囊纵隔法5例,联合皮瓣法3例;尿瘘中膀胱粘膜法1例,包皮内板法3例,阴茎阴囊纵隔法24例,联合皮瓣法3例。结论根据尿道下裂类型选择不同的术式+尿流改道,并严格遵守整形外科的原则是尿道下裂手术成功的关键。
Objective To evaluate the choice of different operative procedures and how to improve the success rate by review the treatment for 445 cases of different congenital hypospadias. Methods 445 cases of congenital hypospadias from 1998 to 2003 treated in our hospital were reviewed.331 patients underwent pedicle skin flap of penis and midline scrotal raphe urethroplasty;52 patients underwent urethroplasty of penis inner plate with pedicle skin flap; 61 patients underwent combinative urethroplasty for skin flap of prepuce with penis scrotum; 21 patients underwent bladder mucosa substitution for urethral grafting urethroplasty;all of the patients underwent suprapubic cystostomy. Results The operative success rate was 90.6%,and complication rate was 9.4%. 11 cases were complicated by urethral stricture,one of them being underwent the bladder mucosa graft urethroplasty, 2 the pedicle skin flap of prepuce combinative urethroplasty, 5 the middline scrotal raphe flap urethroplasty, 3 combinative skin flap surgery urethroplasty. 31 patients were complicated by urethral fistula,1 of them being underwent the bladder mucosa graft urethroplasty,3 pedicle skin flap of prepuce urethroplasty, 24 the midline scrotal raphe flap urethroplasty, 3 the associated skin flap surgery urethroplasty. Conclusions The key point of successful treatment for hypospadias is the choice of surgical procedure according to the hypospadias type,careful operation,and strictly obeying the principle of plastic surgery.
出处
《临床小儿外科杂志》
CAS
2004年第2期97-99,共3页
Journal of Clinical Pediatric Surgery
