包茎局部狭窄环超微结构研究

Ultrastructural study on stenosis ring of foreskin in phimosis

目的：了解包茎局部狭窄环组织在类固醇外用治疗前后超微结构的变化。方法异常狭窄环手术标本组织3例（包茎组），正常对照组手术标本组织3例（正常对照组），局部类固醇外用治疗后痊愈手术标本组织3例（用药后痊愈组）。于门诊手术过程中选取环切的包皮组织，包茎组取狭窄环处组织1～2 g，正常对照组和用药后痊愈组取相应的包皮外环口组织1～2 g，按电镜取材要求处理包埋并制片后，电镜观察局部组织超微结构。结果电镜观察发现包茎组狭窄环组织中存在异常堆积成束的胶原纤维。正常对照组和用药后痊愈组中未发现此类成纤维细胞和异常胶原堆积现象。结论包茎狭窄环内存在异常堆积的胶原纤维。包茎狭窄环处呈现高张力而缺乏足够的弹性与胶原纤维异常堆积有关。本研究也提示局部类固醇可能通过降解异常堆积的胶原纤维使包茎局部狭窄环松解而达到治愈包茎的目的。

Objective To understand the ultrastructural changes in stenosis ring during the process of topical steroid treatment in phimosis.Methods 9 specimens randomly selected in normal control group, phimosis group,steroid therapy group.Each group has 3 cases.According to electronmicroscopy,material requirements,1-2 g tissue of the outer ring from the foreskin in circumcision was cut.The ultrastructure of the local tissue was observed by electron microscopy.Results In phimosis group,many abnormal collagen fibrils accumulations can be found in intercellular substance.In other groups the phenomenon was not found.Conclusion Many abnormal collagen exist in the narrow ring of prepuce.The abnormal accumulation of collagen fibrils may be caused by the lack of elasticity of the narrow ring of prepuce.The topical steroids may relieve the strain by degrading the accumulation so that so that phimosis could be cured.