Mathieu术联合舌形皮瓣覆盖法在远端尿道下裂合并小阴茎头畸形中的应用

Mathieu combined with tongue-shaped flap covering in distal hypospadias with micropenis head deformity

目的 观察Mathieu术联合舌形皮瓣覆盖法在远端型尿道下裂合并小阴茎头畸形患儿中的疗效。方法 回顾性分析2018年1月—2021年6月本院收治的远端型尿道下裂合并小阴茎头畸形的72例患儿的临床资料,其中35例行改良Mathieu术联合舌形皮瓣与阴茎头裂成形尿道外口(研究组),37例行传统Mathieu术(对照组),随访两组术后尿道狭窄、尿瘘、尿道憩室、阴茎头裂开发生情况,并进行比较分析。结果 研究组较对照组尿瘘发生率显著减低(P=0.028),分别为2例(5.27%)和9例(24.32%);研究组与对照组在尿道狭窄、阴茎头裂开和尿道憩室上差异无统计学意义(P>0.05):尿道狭窄分别为1例(2.86%)和1例(2.70%),阴茎头裂开分别为1例(2.86%)和3例(8.11%),尿道憩室分别为0例(0%)和2例(5.41%)。结论 使用Mathieu术联合舌形皮瓣覆盖法治疗远端型尿道下裂合并小阴茎头畸形的患儿可降低术后并发症的发生率,以期达到较高的手术满意度和外观满意度,减少手术给患儿带来的伤害,使患儿心理更健康。

Objective To explore the efficacy of Mathieu combined with tongue-shaped flap covering in children with distal hypospadias and micropenis head deformity.Methods The clinical data of 72 patients with distal hypospadias complicated with micropenis treated during Jan.2018 and Jun.2021 were retrospectively analyzed, including 35 patients who underwent modified Mathieu combined with tongue-shaped flap and external urethral orificium(study group),and 37 patients who underwent traditional Mathieu(control group).Urethral stricture, urethral fistula, urethral diverticulum and penile head cleft were compared between the two groups.Results Urinary fistula occurred in 2 cases(5.27%) and 9 cases(24.32%) in the study group and control group, respectively, the incidence being much lower in the study group(P=0.028).Urethral stricture occurred in 1 case(2.86%) and 1 case(2.70%) in the study group and control group, respectively;penile head dehiscence in 1 case(2.86%) and 3 cases(8.11%);urethral diverticulum in 0 case(0%) and 2 cases(5.41%).There were no significant differences between the two groups in the incidence of urethral stricture, urethral dehiscence and urethral diverticulum(P>0.05).Conclusion Mathieu combined with tongue-shaped flap covering to treat children with distal hypospadias with micropenis head deformity can reduce the incidence of postoperative complications, achieve high surgical satisfaction and appearance satisfaction in the first phase, reduce harm caused by surgery, and promote patients’ psychological health.