不同外科皮瓣修复38例尿道下裂的临床疗效

The Different Surgical Flap in 38 Cases the Clinical Efficacy of Hypospadias

目的观察不同外科皮瓣修复尿道下裂的临床疗效。方法选择我院自2009年1月至2012年6月收治的38例尿道下裂患儿的临床资料,根据患儿不同的症状给予不同外科皮瓣修复尿道下裂。结果阴茎阴囊皮瓣加尿道板、阴茎阴囊皮瓣、尿道板、包皮瓣加尿道板、包皮瓣在治疗尿道下裂的临床平均治愈率分别为77.8%、70.0%、71.4%、85.7%、60.0%,对各组临床治愈率进行对比,无显著性差异(P>0.05),在发生尿瘘方面,采用尿道板最高,其次为包皮瓣,各组间结果对比均具有显著性差异(P<0.05)。阴茎阴囊皮瓣+尿道板、包皮瓣+尿道板对比,无显著性差异(P>0.05),尿道板与包皮瓣对比,结果无显著性差异(P>0.05),本组尿道板、包皮瓣+尿道板、包皮瓣组未发生其他并发症,与阴茎阴囊皮瓣+尿道板、阴茎阴囊皮瓣对比,结果具有显著性差异(P<0.05)。结论针对不同尿道下裂情况选择适宜的外科皮瓣以提高临床治愈率,改善患儿预后。在治疗过程中,应注意尿瘘等并发症的预防及处理。

Objective To observe the different surgical flaps repair of hypospadias clinical efficacy. Method To select our hospital from Jan 2009 to Jun 2012 were treated 38 cases of hypospadias clinical data, according to the different symptoms children give different surgical flap repair hypospadias. Results Penile scrotal flap with urethral plate, penile scrotal flap, urethral plate, preputial flap with urethral plate and preputial flap in the treatment of hypospadias clinical average cure rate were 77.8%, 70.0%, 71.4%, 85.7%, 60.0%. The clinical cure rate were compared, no significant difference （P〉0.05）. In the event of urethral fistula, urethral plate is highest, followed by preputial flap. Comparing the result of each group were significant difference （P〈0.05）. Penile scrotal flap with urethral plate, preputial flap with urethral plate contrast no significant difference （P〉0.05）. Urethral plate and preputial flap contrast no significant difference （P〉0.05）. The urethral plate, preputial flap with urethral plate preputial flap group did not happen other complications, contrast penile scrotal flap with urethral plate and penile scrotal flap with a significant difference （P〈0.05）. Conclusion Choose the appropriate surgical flap according to different hypospadias situation in order to improve the clinical cure rate, improve the prognosis of patients. During the course of treatment, should pay attention to the prevention and treatment of urinary fistula and other complications.