改良Snodgrass术治疗尿道下裂的临床研究

Modified Snodgrass technique for hypospadias

目的:探讨改良Snodgrass术治疗尿道下裂的临床疗效。方法:回顾性分析2008年1月至2016年10月收治尿道下裂病例212例,其中94例行改良Snodgrass术,即增加1根丝线用于缝合,便于术后拆除尿道板缝线;118例行传统Snodgrass术。改良法采用术后第10天拆除尿道板缝线。比较两种手术成功率、术后并发症情况。结果:改良Snodgrass术组和传统Snodgrass术组手术成功率分别91.49%、81.36%,其差异有统计学意义(P<0.05),切口感染、尿瘘、尿道狭窄等的发生率:改良Snodgrass术组分别为4.26%、6.38%、2.13%,传统Snodgrass术组分别为12.71%、16.10%、2.54%。切口感染和尿瘘的发生率差异有统计学意义(P<0.05),尿道狭窄的发生率差异无统计学意义(P>0.05)。结论:改良Snodgrass术可以提高手术成功率,降低术后切口感染和尿瘘的发生率,有临床推广价值。

Objective： To investigate the clinical effect of modified Snodgrass surgical technique in the treatment of hypospadias. Methods： We retrospectively analyzed the clinical data about 212 cases of hypospadias treated by urethroplasty from January 2008 to October 2016,94 with the modified Snodgrass technique,namely with a silk line in addition to the urethral suture to make easier postoperative removal of the suture（ group A）,and the other 118 with the conventional Snodgrass technique（ group B）.The urethral suture was removed at 10 days after surgery for the patients in group A. We compared the success rate of surgery and incidence of postoperative complications between the two groups. Results： Compared with group B,group A showed a significantly higher success rate of surgery（ 81. 36% vs 91. 49%,P 〈0. 05） but lower incidence rates of postoperative incisional infection（ 12. 71% vs4. 26%,P 〈0. 05） and urinary fistula（ 16. 10% vs 6. 38%,P 〈0. 05）. No statistically significant difference was found in the incidence of urethral stenosis between the two groups（ 2. 54% vs 2. 13%,P 〉0. 05）. Conclusion： The modified Snodgrass technique can improve the success rate of surgery and reduce the incidence rates of incisional infection and urinary fistula,which deserves wide clinical application.