单人操作与双人操作一次性包皮环切缝合器在包皮环切术中的临床疗效对比

Clinical effect of two-person of and one-person operations of disposable circumcision stitching instrument

目的 探讨单人操作与双人操作一次性包皮环切缝合器方法对于包皮过长和包茎患者的疗效对比.方法 前瞻性地选取2015年3月-2017年8月就诊于徐州医科大学附属医院泌尿外科门诊的340例包茎和包皮过长患者,采用随机数字表法将340例患者分为单人操作的一次性包皮环切缝合器手术（观察组）和双人操作的一次性包皮环切缝合器手术（对照组）.观察组患者188例,其中包茎患者22例,包皮过长患者166例;对照组患者152例,其中包茎17例,包皮过长135例.比较两组患者的手术时间、术中出血量、术后吻合钉缺失、术后2h疼痛、术后水肿、术后并发症（包括术后包皮系带偏移、系带吻合过短、术后感染）、术后患者满意度等情况.计量资料以均数±标准差（（x）±s）表示,组间比较采用t检验;计数资料以百分率（％）表示,组间比较采用χ^2检验.结果 所有手术均通过一次性包皮环切缝合器顺利完成.在手术情况方面,观察组和对照组手术时间分别为（7.76±0.45） min和（7.86±0.91） min,差异无统计学意义（P＞0.05）.在术中出血量方面,观察组为（1.77±0.22） ml,对照组为（1.72±0.26） ml,差异无统计学意义（P＞0.05）.在吻合钉缺如、术后2h疼痛评分方面,观察组和对照组相比差异无统计学意义（P＞0.05）.在术后并发症方面,观察组术后包皮系带偏移率为1.11％,明显低于对照组5.92％,差异具有统计学意义（P＜0.05）.在术后3d水肿,术后系带吻合过短、患者满意度和术后感染等方面,观察组和对照组相比差异无统计学意义（P＞0.05）.结论 单人操作一次性包皮环切缝合器不仅劳动成本低,效率高,操作性强,而且患者术后临床效果好,值得在临床一线的推广.

Objective To compare the clinical effect of two-person operations of disposable circumcision stitching instrument and one-man operations of disposable circumcision stitching instrument.Methods Clinical data of 340 patients with redundant prepuce or phimosis from March 2015 to August 2017 were randomly divided into control group which patients with two-person operation of disposable circumcision stitching instrument and study group which patients with one-man operation of disposable circumcision stitching instrument were reviewed prospectively.There were 188 patients in the study group,including 22 patients with phimosis and 166 patients with redundant prepuce;Among the 152 patients in the control group,there were 17 cases with phimosis and 135 cases with redundant prepuce.Two groups with operation time,intraoperative blood loss,postoperative skin staple missing,2 hours postoperative pain,postoperative edema,the swelling subsided time,postoperative complications,postoperative patient satisfaction,and so on.Measurement data were represented as （x） ± s,and comparison between groups was analyzed using t test;count data were represented as percentage and comparison between groups was analyzed chi-square.Results All operations were finished successfully for the patients by two-person or one-man of operations of disposable circumcision stitching instrument.In terms of operation,the operation time of the observation group and the control group was （7.76 ±0.45） minutes and （7.86 ±0.91） minutes respectively,and the difference was not statistically significant（P 〉 0.05）.Intraoperative hemorrhage of observation group and control group were （1.77 ± 0.22） ml and （1.72 ± 0.26） ml,and the difference was not statistically significant （P 〉 0.05）.There was no statistically significant difference between the observation group and the control group （P 〉 0.05） in the postoperative 2 hours pain score and skin staple missing.In the postoperative complications,the deviation rate of the prepuce was 1.11%,significantly lower than the control group 5.92%,and the difference was statistically significant （P 〈 0.05）.There was no statistically significant difference between the observation group and the control group in terms of edema on the third postoperative day,short postoperative anastomosis,patient satisfaction,and postoperative infection.Conclusion The way of one-man operation of disposable circumcision stitching instrumente not only saves labor costs,but also has a good postoperative clinical effect,meanwhile,it has high efficiency and strong operability,and is worthy of promotion for clinical first-line urologists.