先天性尿道下裂68例手术体会
- 关键词:
- 尿道下裂/外科学
- 摘要:
- 目的总结68例小儿尿道下裂的治疗经验。方法68例尿道下裂患儿,对阴茎头型患儿采用尿道口前移、阴茎头成形法(MAGPI术式);冠状沟型或距冠状沟较近的阴茎体型采用尿道口基底血管皮瓣法(Mathieu术式);尿道口在阴茎体外2/3段伴有阴茎轻度下弯或无下弯者采用尿道板纵切卷管法或加盖岛状皮板法(Snodgrass术式或Onlay术式);有严重阴茎下弯的所有阴茎体型采用横裁或纵裁包皮岛状皮瓣尿道成形(Duckett术式或Hodgson术式);阴囊型或会阴型用阴囊中缝皮管加横裁包皮岛状皮瓣成形尿道(Duplay联合Duckett术式)。结果治愈62例,并发尿道瘘3例,尿道狭窄4例,治愈率为89.8%(61/68)。65例获随访,平均随访时间20.5个月(3～39个月),随访期间患儿排尿正常。结论选择正确的手术方法,重视术中技巧,选用合适的修复材料,能明显提高手术成功率。
相似文献/References:
[1]杨艳芳,陈国盈,李骥,等.Snodgrass尿道成型术治疗小儿尿道下裂98例[J].临床小儿外科杂志,2008,7(02):31.
[2]陈江谊,马少锋,曹志清,等.T-1型脱落细胞异体组织补片代尿道治疗小儿重度尿道下裂的临床观察[J].临床小儿外科杂志,2008,7(04):0.
[3]郑洪,谭朝华.喉罩下吸入麻醉加骶麻在小儿尿道下裂成形术中的应用[J].临床小儿外科杂志,2007,6(01):17.
[4]段光琦 毕允力 张敏 管肖浩. Koyanagi手术和改良手术治疗重型尿道下裂[J].临床小儿外科杂志,2011,10(05):389.
[J].Journal of Clinical Pediatric Surgery,2011,10(03):389.
[5]胡志成 刘风昌 王利民. Duckett术式治疗尿道下裂74例[J].临床小儿外科杂志,2012,11(01):32.
[6]吴少峰,何蓉,孙杰,等.腹侧延长术和背侧折叠术在近端型尿道下裂中的疗效对比[J].临床小儿外科杂志,2020,19(07):603.[doi:10.3969/j.issn.1671-6353.2020.07.008]
Wu Shaofeng,He Rong,Sun Jie,et al.Efficacies of ventral lengthening versus dorsal plication for severe ventral curvature during proximal hypospadias repair[J].Journal of Clinical Pediatric Surgery,2020,19(03):603.[doi:10.3969/j.issn.1671-6353.2020.07.008]
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Huang Lugang,Zhang Weiping.Some focal issues of applying tubularized incised plate for repairing hypospadias[J].Journal of Clinical Pediatric Surgery,2020,19(03):1061.[doi:10.3969/j.issn.1671-6353.2020.12.001]
[8]姜心诚,叶惟靖.尿道下裂阴茎下弯矫治策略的选择[J].临床小儿外科杂志,2020,19(12):1066.[doi:10.3969/j.issn.1671-6353.2020.12.002]
Jiang Xincheng,Ye Weijing.Management of penile curvature associated with hypospadias in children[J].Journal of Clinical Pediatric Surgery,2020,19(03):1066.[doi:10.3969/j.issn.1671-6353.2020.12.002]
[9]方一圩,宋宏程.尿道板纵切卷管尿道成形术的历史与演变[J].临床小儿外科杂志,2020,19(12):1070.[doi:10.3969/j.issn.1671-6353.2020.12.003]
Fang Yiwei,Song Hongcheng.History and development of tubularized incised urethral plate urethroplasty[J].Journal of Clinical Pediatric Surgery,2020,19(03):1070.[doi:10.3969/j.issn.1671-6353.2020.12.003]
[10]余克驰,李宁,袁继炎,等.TIP手术治疗儿童尿道下裂的远期疗效分析[J].临床小儿外科杂志,2020,19(12):1076.[doi:10.3969/j.issn.1671-6353.2020.12.004]
Yu Kechi,Li Ning,Yuan Jiyan,et al.Long-term outcomes for the uses of tubularized incised plate procedure in hypospadias surgery[J].Journal of Clinical Pediatric Surgery,2020,19(03):1076.[doi:10.3969/j.issn.1671-6353.2020.12.004]