医用透明硅胶膜在尿道下裂手术伤口包扎中的应用

Application of Mepitel（ Medical silicone net dressings）in the bandaging technology of hypospadias surgery.

目的探讨医用透明硅胶膜（Mepitel）作为尿道下裂手术后阴茎包扎敷料的特点和优势。方法2007年7月至2008年10月作者对35例尿道下裂手术患儿采用Mepitel作为术后阴茎包扎材料，对42例尿道下裂手术患儿采用尼龙纱布作为包扎材料。77例患儿均伴不同程度阴茎下弯，均行一期尿道成形术，手术由同一名医师完成，手术方式包括MAPGI、0nlayDuckett、Mathieu、Snodgrass以及Duckett＋Duplay术等。比较两种材料包扎阴茎所需时间、拆除包扎时间、拆除时疼痛程度、拆除后创面残留分泌物、术后阴茎瘢痕以及并发症等方面的差异。结果两组阴茎包扎时间差异无统计学意义[（2．44±0．83）min vs（2．22±0．60）min，F=5．511，t=1．322，P=0．191）]，拆除包扎时间差异有统计学意义[（1．22±0．67）min vs（4．85±2．90）min，F=22．228，t=-7．864，P=0．000）]。拆除包扎后创面残留分泌物：Mepitel组6例，尼龙纱组19例，差异有统计学意义（x2=6．873，P=0．009）。拆除包扎过程中患儿疼痛评分：Mepitel组优于尼龙纱组[（3．37±1．78）分似（5．794-1．97）分，F=0．726，t=-5．588，P=0．000）]，术后并发症：Mepitel组6例，尼龙纱组12例，差异无统计学意义（x2=1．392，P=0．238）。术后3个月阴茎外观基本无瘢痕：Mepitel组28例（80％），尼龙纱组22例（52．4％），差异有统计学意义（x2=6．396，P=0．011）。结论Mepitel作为尿道下裂手术后阴茎包扎敷料具有损伤小，痛苦小，易操作的优点。

Objective To evaluate the features and advantages of Mepitel as dressings for treatment of hypospadia. Methods A total of 77 one-stage urethroplasty were performed by a single surgeon between July 2007 and October 2008.35 cases used Mepitel as bundled dressing （ group Mepitel）, 42 cases had nylon gauze dressing（ group nylon）. All cases with varying degree of clubbedpenis. The surgical methods included MAPGI, Onlay, Duckett, Mathieu, Snodgrass and Duckett ＋ Duplay. The parameters （ penis time-consuming, postoperative demolishing the dressings time-consuming, releasing pain, wound exudate, Penis skin scar and complication） were observed between two groups. Results There is no difference between two groups in dressings bind time-consuming（ P 〉 0.05 ） and complication（ P 〉 0.05 ）. There were statistical differences in demolishing the dressings time-consuming（ P 〈 0.01 ）, releasing pain（ P 〈 0.01 ）, wound exudate （ P 〈 0.01 ）, and Penis skin scar（ P 〈 0.05）. Conclusions Mepitel has the great advantage of small damage, pain small and easy-to-operate. It is worth of popularizing.