两种包皮切割缝合器行包皮环切术的临床疗效对比研究

A Comparative Study on the Clinical Effects of Circumcision with Two Different Kinds of Disposable Circumcision Suture Devices

【目的】比较改良型一次性包皮切割缝合器和一次性包皮切割缝合器行包皮环切术的临床疗效。【方法】选择2018年3~8月本院门诊收治的108例包皮过长或包茎患者,所有患者均行包皮切割缝合器手术治疗,根据手术切割缝合器的不同将其分为观察组(使用改良型一次性包皮切割缝合器,n=56)和对照组(使用一次性包皮切割缝合器,n=52)。由同一手术医师用两种切割缝合器手术和术后随访。比较两组患者手术时间、术中出血、中转开放手术例数、术后疼痛、术后水肿,带钉时间、术后出血、术后二次手术、术后满意度。【结果】观察组手术时间低于对照组,但差异无统计学意义(P>0.05)。观察组术中出血量低于对照组,差异有统计学意义(P<0.05)。对照组1例因系带扭转中转开放手术,2例因出血及皮下血肿中转开放手术;观察组1例因系带扭转中转开放手术,两者术中中转开放比例比较,差异无统计学意义(P=0.558>0.05)。观察组术后疼痛评分及术后二次手术发生率均低于对照组,但差异均无统计学意义(均P>0.05);观察组术后水肿发生率高于对照组,术后带钉时间低于对照组,差异均有统计学意义(均P<0.05)。观察组术后满意度高于对照组,但差异无统计学意义(P>0.05)。【结论】两种包皮切割缝合器各有优缺点,临床医师根据自己经验及患者情况,选择适应的缝合器。

【Objective】To compare the clinical effects of improved disposable circumcision suture device and disposable circumcision suture device in circumcision.【Methods】A total of 108 patients with long prepuce or phimosis from March to August 2018 were randomly divided into two groups.Patients in the observation group(n=56)received improved-disposable circumcision suture device,while patients in the control group(n=52)received disposable circumcision suture device.Operation time,intraoperative bleeding,number of cases of transfer surgery,postoperative pain,postoperative edema,postoperative nailing time,postoperative second operation,and postoperative satisfaction were compared between the two groups with different kinds of disposable circumcision suture devices.【Results】There were no significant differences(P>0.05)in operation time(P=0.057),intraoperative transition to open(P=0.558),second operation(P=0.481),postoperative pain(P=0.27),or postoperative satisfaction(P=0.856).There were statistically significant differences(P<0.05)in intraoperative bleeding(P<0.001),postoperative edema(P<0.001),and postoperative nailing time.Intraoperative bleeding of the improved disposable circumcision suture device with silicone ring was better than that of the disposable circumcision suture device;the possibility of changing operation was less than the control group.At the same time,the postoperative edema was more obvious than the control group.The postoperative nailing time in the observation group was lower than that in the control group(P<0.05).There was no statistically significant difference of postoperative satisfaction between the two groups(P>0.05).【Conclusion】Both kinds of disposable circumcision suture devices have their own advantages and disadvantages.Clinicians should choose suitable suture device according to their own experience and patient's condition.