商环包皮环切术与CO_2激光包皮环切术临床比较研究

A clinical comparative study of Shang Ring circumcision versus CO_2 laser circumcision

目的：比较商环包皮环切术与CO2激光包皮环切术治疗包茎、包皮过长的临床应用效果。方法：门诊1280例包茎、包皮过长患者,672例行商环包皮环切术,608例行CO2激光包皮环切术,20-30岁年龄段中行商环包皮环切术共557例为商环组（A组）,行CO2激光包皮环切术542例为CO2激光组（B组）,比较两组两种治疗方法的手术时间、医疗费用、切口愈合时间;比较两组术后并发症如切口出血、切口疼痛、包皮水肿、切口裂开以及切口愈合外观。结果：商环组（A组）与CO2激光组（B组）手术时间分别为（5±2）min、（24±5）min;医疗费用分别为（985±47）元、（472±39）元,这两项两组比较差异有统计学意义（P〈0.05）。术后24h内切口疼痛评分分别为（7.3±1.5）、（2.5±0.7）分;术后24h的切口出血A、B组发生率分别为0%（0/557）、0.74%（4/542）,这两项两组比较差异有统计学意义（P〈0.05）。术后包皮水肿A、B组发生率分别为5.21%（29/557）、4.06%（22/542）;术后切口裂开A、B组发生率分别为3.23%（18/557）、2.40%（13/542）,这两项两组比较无统计学意义（P〉0.05）。切口愈合时间A组（18±5）d,B组（16±4）d,两组比较差异无统计学意义（P〉0.05）。切口愈合外观A组愈合好的比例占99.46%（554/557）,B组愈合好的比例占8.86%（48/542）,两组比较差异有统计学意义（P〈0.05）。结论：商环包皮环切术手术操作简单,手术时间短,术后并发症相对少,切口愈合更美观,符合就诊者愿望与需求,值得推广。

Objectives： To compare the clinical efficacy of Shang Ring circumcision and CO2 laser circumcision in the treatment of phimosis and redundant prepuce. Methods： Among 1280 cases of phimosis and redundant prepuce,there were 672 cases of Shang Ring circumcision and 608 cases of CO2 laser circumcision. In the 20- 30 years old group,there were 557 cases of Shang Ring circumcision（ group A） and 542 cases of CO2 laser circumcision（ group B）. Operation time,treatment cost,wound healing time and postoperative complications such as incision bleeding,incision pain,prepuce edema,wound dehiscence and postoperative penile appearance of the two groups were compared. Results： For group A and group B,the operative time was（ 5 ± 2） min and（ 24 ± 5）min respectively; treatment cost was（ 985 ± 47） yuan and（ 472 ± 39） yuan respectively,both with statistically significant difference（ P〈0. 05）. The 24- hour pain score after operation was（ 7. 3 ± 1. 5） and（ 2. 5 ± 0. 7） respectively; 24- hour incision bleeding rate after operation was 0（ 0 /557） and 0. 74%（ 4 /542） respectively,both with statistically significant difference（ P〈0. 05）. The prepuce edema rate after operation was 5. 21%（ 29 /557）and 4. 06%（ 22 /542） respectively; wound dehiscence rate after operation was 3. 23%（ 18 /557） and 2. 40%（ 13 /542） respectively,both without statistically significant difference（ P〉0. 05）. The wound healing time was（ 18 ± 5） d and（ 16 ± 4） d respectively,with statistically significant difference（ P〈0. 05）. The healed rate in group A and B was 99. 46%（ 554 /557） and 8. 86%（ 48 /542） respectively,with statistically significant difference（ P〉0. 05）. Conclusions： Compared with CO2 laser circumcision,Shang Ring circumcision is simpler in performance and has shorter operative time with relatively fewer complications. Its appearance of wound healing is morebeautiful,which is in line with the wishes and needs of patients,thusly worthy of clinical applications.