三种包皮环切术的临床疗效比较

Comparison of clinical observation on Three circumcision

目的:比较传统包皮环切术、袖套式包皮切除术和改良包皮环切术治疗包皮过长或包茎患者的临床疗效。方法:回顾性分析采用传统的包皮环切(A组)(n=116)、袖套式包皮切除术(B组)(n=104)和改良的包皮环切术(C组)(n=115)治疗包茎或包皮过长335例患者的临床资料,比较三种术式的手术时间、术中出血量、术者对手术的满意度、术后疼痛持续时间、术后并发症、创口完全愈合时间、术后阴茎外观异常、包皮水肿程度。结果:B组的手术时间明显多于A组和C组,而术中出血量少于A组和C组(P<0.05)。A组、B组、C组创口完全愈合时间分别为(17.6±5.6)d、(12.3±1.8)d、(12.8±2.7)d,B组、C组创口完全愈合时间明显优于A组(P<0.05)。术后疼痛持续时间A组、C组明显短于B组。C组在术者满意度、防止术后出现阴茎外观异常、术后水肿程度方面明显优于A组和B组(P<0.05)。结论:改良的包皮环切术结合传统包皮环切术和袖套状切除术的优点,治疗包皮过长或包茎更具有优越性。

Objective To compare the clinical effects of conventional,sleeve and modified circumcisions in the treatment of redundant prepuce and phimosis. Method We reviewed the clinical data of 335 patients with redundant prepuce or phimosis,116 patients were treated by conventional circumcision（ A group）,104 patients were treated by sleeve circumcision（ B group） and 115 patients were treated by modified circumcision. We documented operation time,intra-operative blood loss,duration pain time,surgeons＇ satisfaction,incision healing time,degrees of preputial edema,postoperative complications,satisfaction with penile appearance. Results B group extended the operation time was more and intra-operative blood loss was less as compared with A group and C group（ P 〈0. 05）. The postoperative incision healing time was（ 17. 6 ± 5. 6） d in A group,（ 12. 3 ± 1. 8） d in B group and（ 12. 8 ± 2. 7） d in C group,it was significantly shorter in B and C group than in A group（ P 〈0. 05）. As for the surgeons＇ satisfaction,degree of preputial edema and preventing postoperative penile abnormal appearance C group was significantly better than A group and B group（ P 〈0. 05）. Conclusion Modified circumcision methods has the advantages of conventional and sleeve circumcisions. Modified circumcision has more advantages in the treatment of redundant prepuce and phimosis.