改良尿道板纵切卷管尿道成型术治疗儿童尿道下裂６例
- 摘要:
- 目的 总结改良的分层覆盖缝合尿道板纵切卷管尿道成型术（ＴＩＰ，ＴｕｂｕｌａｒｉｚｅｄＩｎｃｉｓｅｄＰｌａｔｅ）在儿童尿道下裂手术中的应用经验。方法 ２０１０年１月至２０１２年１月作者应用ＴＩＰ法治疗尿道下裂患儿６２例，年龄６个月至７岁，其中５例为再次手术患儿。尿道板纵切卷管尿道成型后改良方法：采用阴茎背侧皮肤下带蒂血管筋膜转移至腹侧人工尿道上覆盖后，再用全层包皮两翼向腹侧包绕的分层缝合覆盖的方法。结果 ６２例患儿中，５７例术后阴茎伸直，外形美观，排尿正常。术后出现尿瘘２例，经二次手术修补尿瘘及尿道成型失败后再手术３例，一次手术成功率为９１．９％。结论 ＴＩＰ分层覆盖缝合后人工尿管血运改善，成功率高。手术时应使尿道板纵切卷管无张力缝合成型，分层解剖时避免损伤各层供应血管，是改良ＴＩＰ的关键。
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备注/Memo
作者单位：重庆医科大学附属永川医院儿童外科（重庆市，４０２１６０）Ｅｍａｉｌ：１９６２８０６５５３＠ｑｑ．Ｃｏｍ