尿道下裂患儿不同手术方法的临床分析

Clinical analysis of different surgical procedures for hypospadia

目的:总结分析尿道下裂181例患儿不同手术方法的临床疗效及并发症发生率。方法:收集2000～2006年本院收治的181例尿道下裂患儿临床资料,分析不同部位、不同术式的临床疗效,统计尿道瘘及尿道狭窄的发生率及年龄段分布率。结果:181例患儿完全治愈147例(81.2%),发生尿道瘘17例(9.4%),尿道狭窄15例(8.3%)。尿道口前移加阴茎头成形术(MAGPI)患儿的尿道瘘、尿道狭窄发生率均为0,Mathieu法分别为5%和10%,Dennis-Brown法为20%和13.3%,膀胱黏膜法一期尿道成形术分别为14%和8.8%;尿道瘘和尿道狭窄发生率的年龄段分布无显著区别。结论:不同类型尿道下裂应采用不同的手术方式,尿道瘘和尿道狭窄是需要预防的重要术后并发症。

Objective：To analyse the clinical effects and the incidence of complication of different surgical procedures for hypospadia in 181 cases.Methods：From 2000 to 2006,The clinical effects of different surgical procedures in 181 patients with hypospadia treated in our hospital were studied,the incidence rates of urethral fistula and urethral stricture were studied too.Results：The complete cure rate in 181 cases was 81.2%（147 cases）,the incidence rates of urethral fistula and urethral stricture were 9.4%（17 cases） and 8.3%（15 cases） respectively.The incidence rates of both the stricture and fistula were 0% for MAGPI,but which were 5.0% and 10.0% respectively for Mathieu operation,20% and 13.3% for Dennis-Brouwn procedure as well as 14.0% and 8.0% for bladder flap procedure.The stricture rate and fistula rate in different ages had no any difference.Conclusion：Different surgical procedures should be taken for the different types of hypospadia, but urethral stricture and urinary fistula were the main complications after operation.