新型包皮套扎器行包皮环切术和传统包皮环切术的比较研究

A novel disposable circumcision device versus conventional surgery in the treatment of redundant prepuce and phimosis

目的:比较新型包皮套扎器行包皮环切术与传统包皮环切术治疗包皮过长及包茎的临床效果及并发症。方法:750例包皮环切术的患者分为两组,450例采用新型包皮套扎器包皮环切术(套扎器组),300例采用传统包皮环切术(传统组),分析和比较两组患者的手术时间、出血量、疼痛评分(视觉模拟评分法,VAS)、术后恢复时间和术后感染的发生率,及术后外观满意度等。结果:所有手术均顺利完成,套扎器组的手术时间(3.78±0.42)min、术中出血量(2.39±1.01)ml、术中疼痛评分(0.14±0.36)分,术后6 h疼痛评分为(0.32±0.78)分,拆环时疼痛评分(3.35±1.42)分,术后包皮完全愈合时间(7.61±1.60)d,愈合后外观满意度97.8%(440/450),术后出血及血肿0.89%(4/450);传统手术组分别为(26.24±3.99)min,(10.80±3.57)ml,(2.30±1.46)分,(3.03±1.56)分,(2.43±1.67)分,(8.57±1.37)d,86%(258/300),3%(9/300);以上8项指标均有统计学意义(P<0.05)。套扎器组拆套扎器前夜间疼痛评分(1.45±1.02)分,拆环后包皮内板及系带处水肿0.89%(4/450),传统手术组分别为拆线前夜夜间疼痛评分(1.38±0.92)分,拆线后水肿2.33%(7/300),以上两项无统计学意义(P>0.05)。两组发生包皮裂开各1例,均无术后明显感染及延迟愈合情况发生。结论:新型包皮套扎器包皮环切术具有手术时间短,术中术后出血少,疼痛轻,术后外观满意度高,安全度高,受术者易于接受等优点,值得临床推广应用。

Objective： To compare the clinical effect of a novel disposable circumcision device Ring with that of conventional circumcision in the treatment of redundant prepuce and phimosis. Methods ： Totally, 750 patients with redundant prepuce or phimosis underwent Ring circumcision （group A, n = 450） or conventional circumcision （group B, rt = 300）. We recorded the operation time, intraoperative blood loss, Visual Analogue Scale （VAS） intraoperative pain scores, postoperative complications, wound healing time, and patients＂ satisfaction with postoperative penile appearance, followed by comparison of the collected data between the two groups of patients. Results： All the operations were successfully completed. Group A, as compared with B, showed significantly shorter operation time （ [ 3.78 ± 0.42 ] vs [ 26.24 ± 3.99 ] min, P 〈 0.05）, less intraoperative blood loss （ [ 2.39 ± 1.01 ] vs [ 10.80 ± 3. 571 ml, P 〈0.05）, lower pain scores intranperatively （0.14 _＋ O. 36 ＊Js 2.30 ± 1.46, P 〈0.05）, 6 hours postoper- atively （0.32 ± 0.78 vs3.03 ± 1.56, P 〈0.05） and at tile ring removal （3.35 ± 1.42 vs2.78 ± 1.43, P 〈0.05）, shorter wound healing lime （ [7.61 ± 1.60 ] vs [ 8.57 ± 1.37 ] d, P 〈 0.05 ）, higher satisfaclion with posloperative penile appearance （ 97.8% [ 440/450 ] vs 86% [ 258/300 ], P 〈 0.05 ）, an, I lower incidence of postoperative bleeding or hemamma （0.89% [ 4/450 ] vs 3% [ 9/300] , P 〈 O. 05）. No statistically significant differences were obsmwed between groups A and B in the nocturnal pain score before the ring removal （ 1.45±1.02 t：s 1.38 ± 0.92, P 〉 0.05） or the postoperative incidence rate of edema （0.89% [4/450 ] vs 2.33% [ 7/300 ] , P 〉 O. 05）. There were no significant postoperative infections or delayed incision healing except for 1 case of wound dehiscence in eaeh group. Conclusion： Ring cilx：umcision, wilh its advantages of shorter operation time, less blood loss and pain, higher safety, and belier postoperative penile appearance, is easily aeeepted by the patients and deserves wide elinieal application.