包皮环扎术治疗小儿包皮过长803例

Foreskin cerclage in the treatment of phimosis, redundant prepuce in children：a report of 803 cases

目的 总结运用包皮环扎术治疗小儿包茎包皮过长的治疗经验以及术后并发症的处理方法.方法 回顾性分析2009年7月至2012年6月我科运用包皮环扎术治疗小儿包茎、包皮过长803例病例资料.年龄2～13岁,平均6.9岁.包茎516例,包皮过长287例,包茎与龟头粘连121例,包茎合并内板下积垢217例,尿路感染病史13例,有气囊扩张术治疗病史30例.结果 799例成功完成包皮环扎术,4例转传统包皮环切术.手术时间5～12 min,平均7 min.术中出血1～12 mL.塑料环扎环脱落时间7～14 d,平均10 d.脱落后切缘整齐、美观.塑料环松脱1例,严重水肿22例,内板出血10例,感染3例,龟头嵌顿4例,塑料环不脱落8例.总的并发症发生率为6.01%.结论 包皮环扎术治疗小儿包茎、包皮过长手术简单,手术时间短、出血少、组织创伤小、患儿痛苦小、术后可洗浴、无需拆线等优点,适合基层医院推广应用.

Objetive To summarize the treatment experience of foreskin cerclage in the treatment of pe- diatric phimosis and redundant prepuce, to summarize the treatment method of postoperative complications. Methods A retrospective analysis of 803 cases information of curing phimosis and redundant prepuce in chil- dren using the foreskin eerclage, in our department from 2009 July to 2012 June. The age ranged from 2 to 13 years old, average 6.9 years old. Phimosis 516 cases, redundant prepuce 287 cases, phimosis and balanus ad- hesion 121 cases, phimosis complicated inner plate fouling 217 cases, urinary tract infection history 13 cases, 30 cases have a history of balloon dilation operation. Results 799 eases were successfully completed the fore- skin eerclage, 4 cases changed traditional circumcision. Operation time 5 - 12 min, the average 7min. Intraop- erative bleeding from 1 to 12 mL. Plastic ring fall off time 7 - 14 d, the average 10 d. Operation margin tidy, beautiful. Plastic ring loose 1 case, severe edema 22 cases, internal plate hemorrhage 10 cases, infection 3 ea- ses, balanus incarcerated 4 cases, plastic ring does not fall off 8 cases. The overall complication rate was 6.01%. Conclusions The foreskin eerclage curing pediatric phimosis, redundant prepuce, operation simple, short operation time, less bleeding, less tissue trauma, less pain for children, postoperative can wash bath, postoperative no stitches, suitable for primary hospitals application.