改良包皮岛状皮瓣尿道成形术对小儿重度尿道下裂预后的影响

Effect of improved urethroplasty with preputial island flap on prognosis of children with severe hypospadias

目的探讨改良包皮岛状皮瓣尿道成形术(Duckett术)对小儿重度尿道下裂预后的影响。方法回顾性分析2011年3月-2015年12月在该院行手术治疗的重度尿道下裂患儿42例,其中行改良Duckett术的22例患儿为观察组,行Duckett术的20例患儿为对照组。比较两组患儿手术成功率、手术时间、术中出血量、下床活动时间、住院天数、疼痛评分及并发症发生率。结果术后观察组成功率(86.36%)明显高于对照组(50.00%),差异有统计学意义(P<0.05)。观察组手术时间、术中出血量、下床活动时间、住院天数及疼痛评分均低于对照组,除手术时间外,其余指标组间比较差异均有统计学意义(P<0.05)。观察组术后并发症发生率(9.09%)明显低于对照组(40.00%),差异有统计学意义(P<0.05)。结论改良Duckett术治疗小儿重度尿道下裂术中出血量少,手术及住院时间短,患儿疼痛轻,能够尽早下床活动且并发症发生率低,可广泛推广使用。

Objective To explore the effect of improved urethroplasty with preputial island flap （ Duckett surgery） on prognosis of chil- dren with severe hypospadias. Methods Forty-two children with severe hypospadias treated in the hospital from March 2011 to December 2015 were analyzed retrospectively, then they were divided into two groups, 22 children in observation group were treated by improved Duck- ett surgery, while 20 children in control group were treated by Duckett surgery. The successful rates of surgery, operation time, the amounts of blood loss during operation, the time of out-of-bed activity, hositalization time, pain scores, and incidence rates of complications in the two groups were compared. Results The successful rate of surgery in observation group was 86. 36%, which was statistically significantly higher than that in control group （50. 00% ） （P〈0. 05） . The operation time, the amount of blood loss during operation, the time of out- of-bed activity, hospitalization time, and pain score in observation group were lower than those in control group, there were statisitcally sig- nificant differences in the amount of blood loss during operation, the time of out-of-bed activity, hositalization time, and pain score （P〈 0. 05）. The incidence rate of complications in observation group was 9.09%, which was statistically significantly lower than that in control group （ P〈0. 05） . Conclusion Improved Duckett surgery has the advantages of little intraoperative blood loss, short operation time and hospitalization time, slight pain, early out-of-bed activity, and low incidence rate of complications in treatment of children with severe hypo- spadias, which can be widely used.