泡沫敷料联合粘贴式阴茎罩在小儿包皮环切术后的应用

Application of foam dressing combined with adhesive penile hood after circumcision in children

目的探讨泡沫敷料联合自制的粘贴式阴茎罩固定在小儿包皮环切术后切口中的应用效果。方法选取2020年1—12月在宣城市人民医院泌尿外科行包皮环切术的101例患儿,采用随机数字表法分为试验组50例和对照组51例。试验组采用泡沫敷料联合自制的粘贴式阴茎罩固定法,对照组采用常规的无菌纱布敷料联合简易塑料篓固定法。比较2组患儿术后出血、包皮水肿、切口疼痛、并发症发生率及患儿家属对术后包扎与固定的满意度。结果试验组患儿术后包皮轻度、中度、重度水肿发生率分别为88.00%(44/50)、12.00%(6/50)、0,对照组分别为43.14%(22/51)、45.10%(23/51)、11.76%(6/51),差异有统计学意义(Z=-4.80,P<0.05);试验组患儿术后24 h及换药时疼痛评分分别为(3.50±1.04)、(2.48±0.54)分,低于对照组的(5.31±1.36)、(7.12±0.97)分,差异有统计学意义(t=7.53、29.66,均P<0.05);试验组患儿术后感染与尿潴留并发症发生率分别为0、2.00%(1/50),低于对照组的7.84%(4/51)、7.84%(4/51),差异有统计学意义(Fisher确切概率法,P<0.05);试验组患儿家属满意度为96.00%(48/50),高于对照组的78.43%(40/51),差异有统计学意义(χ^(2)=6.95,P<0.05)。结论采用泡沫敷料联合粘贴式阴茎罩用于包皮环切术后,可减轻包皮水肿及疼痛程度,降低并发症发生率,并提高患儿家属满意度,值得同行借鉴。

Objective To investigate the effect of applying foam dressing combined with self-made adhesive penile hood fixation in children after circumcision.Methods A total of 101 cases of children who received circumcision from January to December 2020 in the urology department of the People′s Hospital of Xuancheng City were selected.The patients were randomly divided into experimental group(50 cases)and control group(51 cases).In the experimental group,the incision was wound with foam dressing combined with the self-made adhesive penile hood fixation method,while in the control group,the incision was wound with the conventional sterile gauze dressing combined with the simple plastic basket fixation method.The postoperative incision bleeding,prepuce edema,incision pain,incidence of complications and the satisfaction of the children′s family members on postoperative dressing and fixation were compared between the two groups.Results The incidence of prepuce edema in the experimental group was 88.00%(44/50),12.00%(6/50),0,which in the control group was 43.14%(22/51),45.10%(23/51),11.76%(6/51),and the difference between the two groups was statistically significant(Z=-4.80,P<0.05).In the experimental group,pain score at 24 hours after operation and at the time of dressing change were 3.50±1.04,2.48±0.54,respectively,which were lower than that of the control group 5.31±1.36 and 7.12±0.97,and the difference between the two groups was statistically significant(t=7.53,29.66,all P<0.05).The incidence of postoperative infection and urinary retention in the experimental group were 0 and 2.00%(1/50),respectively,which were lower than 7.84%(4/51)and 7.84%(4/51)in the control group,and the difference between the two groups was statistically significant(Fisher′s exact probability method,P<0.05).The degree of family satisfaction in the experimental group was 96.00%(48/50),which was higher than that in the control group(78.43%,40/51),and the difference between the two groups was statistically significant(χ^(2)=6.95,P<0.05).Conclusions The application of foam dressing combined with pasting penile hood after circumcision can reduce the degree of foreskin edema,pain and the incidence of complications,and improve the satisfaction of the children′s family members.