TIP术在小儿尿道下裂中的临床研究

Clinical Research on Urethral TIP Angioplasty for Treatment Pediatric Hypospadias

目的探讨保留尿道板尿道纵切卷管成形术(TIP)治疗小儿尿道下裂的临床疗效。方法选取我院2009年1月至2017年4月采用TIP手术治疗的163例小儿尿道下裂患者,随机分为两组,观察组90例采用游离阴茎头背侧包皮带血管蒂肉膜,中间开口后套过阴茎头转移至阴茎腹侧,覆盖新成形尿道,对照组73例采用尿道板旁的肉膜组织覆盖新建尿道。结果观察组的治疗成功率88.89%,对照组82.20%,差异无统计学意义(P>0.05)。观察组患儿的尿瘘率6.67%,对照组16.44%,差异有统计学意义(P<0.05)。观察组患儿的尿道狭窄率4.44%,对照组4.11%,差异无统计学意义(P>0.05)。结论 TIP术是无阴茎弯曲或合并轻中度阴茎弯曲尿道下裂手术治疗操作简便、成功率高。TIP术后常见的并发症是尿道瘘,但瘘口小,易于修补。

Objective To explore the effect of urethral tubularized incised plate（ TIP） angioplasty on the treatment of pediatric hypospadias. Methods A retrospective study of 163 cases were treated by congenital hypospadias from January 2009 to April 2017. The selected cases were randomly divided into two groups.Observation group are 90 cases,which were intraoperatively used of dorsal penile foreskin pedicled dartos strengthen cover new urethra,and control group were 73 cases which had new built urethra covered by dartos tissue beside urethral plates. Results Observation group treatment success rate was 88. 89%,the control group was 82. 20%,there was no significant difference（ P〉0. 05）. Research group of children with urinary fistula rate was 6. 67%,the control group was 16. 44%,the difference was significant（ P〈0. 05）.Observation group of children with stenosis rate was 4. 44%,the control group was 4. 11%,there was no significant difference（ P〉0. 05）. Conclusion TIP is one of the best surgical operation for no bending penile or merged mild moderate bending penile hypospadias,which is easy and high success rate. Urinary fistula is the main postoperative complications in TIP,but fistula is small and easy to repair.