包皮环切术中不同止血方法对手术效果影响的比较

Comparison of surgical outcomes between different hemostasis methods in circumcision

目的 探讨包皮环切术中采用双极电凝与丝线结扎两种止血方法对手术效果,尤其是术后男性性功能的影响.方法 将350例拟行包皮环切术患者随机分为A、B两组,术中分别采用双极电凝止血法及丝线结扎止血法控制术中出血,术后均随访6个月.比较两组术中情况、术后并发症发生率.应用简易男性性功能评价表（Brief Male Sexual Function Inventory,BMSFI）评价术前及术后6个月性功能变化情况.结果 所有患者手术顺利.A组手术时间、术中失血量较B组减少,差异有统计学意义（P＜0.05）;A组术后总并发症发生率、术后出血及血肿发生率、硬结及疤痕发生率较B组均下降,差异有统计学意义（P＜0.05）;A组术后总体性满意度升高,差异有统计学意义（P＜0.05）,B组术后性功能评分较术前差异无统计意义.结论 包皮环切术中应用双极电凝止血可缩短手术时间,减少术中失血量,减少术后并发症,改善术后男性性功能.

Objectives To investigate the surgical outcomes of two different hemostasis methods （bipolar electrocoagulation and suture） in circumcision,especially the changes of sexual function.Methods 350 patients undergoing circumcision were divided randomly into two groups by different hemostasis methods,including bipolar electrocoagulation（group A） and suture （group B）,every group contains 175 cases.All patients followed up 6 months after operation.The efficiency was evaluted by comparing intraoperative variables,postoperative complications and the change of sexual function before and after operation.Results All cases of circumcision were smoothly accomplished.The operation time was shorter and the intraoperative bleeding amount was less in group A than in group B significantly（P ＜ 0.05）.There were significant differences in the total incidence rate of complications,the tate of postoperative bleeding and hematoma,the rate of thrum reaction and induration （P ＜ 0.05）.The difference of overall sexual satisfaction before and after operation in group A was larger than group B significantly（P ＜0.05）.Conclusions Bipolar electrocoagulation,as a safe and effective hemostasis method,could reduce the rate of postoperative complications,improve overall sexual satisfaction.