经肉膜下间隙行睾丸鞘膜切除术的临床研究

Clinical Research of Vaginectomy via the Plane Beneath the Dartos

目的探讨经肉膜下间隙行睾丸鞘膜切除对减轻术后阴囊肿胀的效果。方法76例成人鞘膜积液病例,随机分为两组研究组38例,采用经肉膜下间隙行睾丸鞘膜切除术;对照组38例,采用传统的睾丸鞘膜翻转术。比较两组病人术前、手术结束时、术后3d、5d的阴囊周长值及术后完全恢复的时间。结果两组术前及手术结束时阴囊周长比较无明显差异(P>0.05),但研究组术后3d、5d阴囊周长值分别为(21.73±1.94)cm和(20.80±1.88)cm,较对照组的(24.29±1.68)cm和(23.09±1.70)cm明显降低(P<0.01),且研究组术后完全恢复时间为(27.58±12.00)d,较对照组的(73.03±19.03)d明显缩短(P<0.01)。术后对照组发生阴囊血肿3例,经切口引流治愈,研究组无阴囊血肿发生。结论与传统的睾丸鞘膜翻转术相比,经肉膜下间隙行睾丸鞘膜切除术能显著减轻术后阴囊肿胀,避免阴囊血肿发生,缩短术后恢复时间,值得推广与应用。

Objective To study the effect of attenuating scrotum-swelling of vaginectomy via the plane beneath the dartos. Methods 76 cases of adult hydrocele were randomly divided into study group （ n = 38 ） underwent vaginectomy via the plane beneath the dartos, and control group （ n = 38 ） underwent conventional vaginal subrvolution. Comparative analysis performed between two groups in terms of scrotum perimeters before operation, at the end of operation, at day 3, day 5 postoperatively and the recovery duration. Results The scrotum perimeters between two groups did not show significant difference before operation and at the end of op- eration （ P 〉 0.05 ）, but significantly decreased （ P 〈 0.01 ） in study group at the day 3 of （ 21.73 ± 1.94 ） cm, day 5 of （ 20.80 ± 1.88 ） em postoperatively when compared with control group of （ 24.29 ± 1.68 ） cm and （ 23.09± 1.70 ）cm respectively. Recovery duration was significantly shorter in study group of （27.58 ± 12.130） d compared with control group of （ 73.03 ± 19.03 ） d （ P 〈 0.01 ）. There were 3 cases of control group experienced hematoma of scrotum and cured by drainage, no such morbidity occurred in study group. Conclusion Compared with the conventional method, vaginectomy via the plane beneath the dartos is recommendable considering the advantages of reducing the scrotum edema, preventing the hemotoma of scrotum, and promoting the recovery.