圣环包皮环切术与传统环切术、袖套状环切术临床疗效对比观察

Therapeutic efficacy of holy-loop,orthodox and sleeve circumcision:a comparative analysis for 298 cases

目的比较圣环包皮环切术、袖套状包皮环切术及传统包皮环切术治疗包皮过长及包茎的临床疗效。方法对298例包皮过长及包茎患者分别行传统包皮环切术(剪刀法)86例(传统组)、袖套状包皮环切术82例(袖套组)、圣环包皮环切术130例(圣环组)。对比分析3组手术时间、术中出血量、术后疼痛持续时间、术后并发症、患者手术前后国际勃起功能评分-5(international index of erectile function,IIEF-5)和勃起功能障碍患者及性伴侣治疗满意度(treatment satisfaction scale,TSS)评分。结果传统组术后疼痛时间[(47.62±13.05)h]显著大于其他2组,术后切口感染率(6.9%)、血肿发生率(15.1%)和包皮畸形发生率(8.1%)显著高于其他2组(P<0.05),术后IIEF-5评分显著降低(P<0.05)而TSS评分无显著变化(P>0.05);袖套组手术时间[(44.21±10.55)min]和术中出血量[(11.02±2.44)ml]显著高于其他2组(P<0.05),术后TSS评分显著提高(P<0.05)而IIEF-5评分无显著变化(P>0.05);圣环组手术时间[(4.37±1.33)min]和术中出血量[(0.79±0.20)ml]显著低于其他2组(P<0.05)、术后阴茎水肿发生率(44.6%)显著高于其他2组(P<0.05),手术后TSS评分显著提高(P<0.05)而IIEF-5评分无显著变化(P>0.05)。结论圣环包皮术操作简单、快捷、安全,较传统术式和袖套状术式临床疗效佳。

Objective To compare the clinical curative effects of orthodox circumcision,sleeve circumcision and holy-loop circumcision on the treatment of phimosis and redundant prepuce.Methods From January 2008 to April 2010,289 patients underwent circumcision in our department.They were classified into 3 groups,86 patients undergoing orthodox circumcision（orthodox group）,82 patients undergoing sleeve circumcision（sleeve group） and 130 patients undergoing holy-loop circumcision（holy-loop group）.All the cases were studied prospectively and comparatively.The operating duration,blood lose,postoperative pain duration and complications among the 3 groups were compared.Results In orthodox group,postoperative painful duration（47.62±13.05 h） was longer than the other 2 groups（P0.05）,and postoperative infection rate（6.9%）,hematoma rate（15.1%） and malformation rate（8.1%） were higher than those of the other groups（P0.05）.In sleeve group,the operating duration（44.21±10.55 min） was longer than the other 2 groups（P0.05） and intraoperative hemorrhagic amount（11.02±2.44 ml） was larger than the other 2 groups（P0.05）.In holy-loop group,the operating duration（4.37±1.33 min） was shorter than the other 2 groups（P0.05）,intraoperative hemorrhagic amount（0.79±0.20 ml） was fewer than the other 2 groups（P0.05）,and postoperative dropsy rate（44.6%） was much higher than the other 2 groups（P0.05）.The difference between preoperative international index of erectile function（IIEF） score and postoperative IIEF score was significant in orthodox group（P0.05）,but not in sleeve group and holy-loop group（P0.05）.The difference between preoperative treatment satisfaction scale（TSS） and postoperative TSS score was significant in sleeve group and holy-loop group（P0.05）,but not in orthodox group（P0.05）.Conclusion Holy-loop circumcision is relatively simple to perform,and requires minimal tissue manipulation.It is quicker,safer and fairly advanced than the other 2 kinds of circumcisions.