术前预防性包皮龟头黏连分离术在包茎和包皮过长行包皮环切术患儿中的应用效果

Effect of preoperative prophylactic preputial glans adhesion separation on phimosis and long preputial circumcision in children

目的:观察术前预防性包皮龟头黏连分离术在包茎和包皮过长行包皮环切术患儿中的应用效果。方法:选取2022年1月1日—9月30日四川护理职业学院附属医院(四川省第三人民医院)泌尿外科收治的346例包茎和包皮过长行包皮环切术患儿为研究对象,依据手术方法不同将患儿分为术前分离组(n=176)和常规手术组(n=170)。观察两组阴茎黏连程度、黏连发生率、手术分离黏连时间、再次手术分离黏连率、术后父母对患儿阴茎外观和创面护理满意度、手术时间。结果:术前分离组术中黏连程度低于常规手术组,术中黏连分离时间短于常规手术组,差异有统计学意义(P<0.05);术前分离组术后黏连程度低于常规手术组,需再次手术分离的患儿占比少于常规手术组,差异均有统计学意义(P<0.05);术前分离组手术时间短于常规手术组,差异有统计学意义(P<0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05);术前分离组家长对患儿阴茎外观满意度、创面护理满意度均高于常规手术组,差异均有统计学意义(P<0.05)。结论:包茎和包皮过长行包皮环切术患儿采取预先分离阴茎龟头黏连,可以降低儿童包皮环切缝合器术中、术后黏连发生率和严重程度,缩短手术时间,能获得较高患儿父母对阴茎外观要求和护理满意度,并不增加手术并发症的风险。

Objective To evaluate the effect of prepuce glans adhesiolysis in children with phimosis or redundant prepuce undergoing circumcision.Methods A total of 346 children with phocimosis and long prepuce undergoing circumcision admitted to the Department of Urology of Affiliated Hospital of Sichuan Nursing Vocational College(Third People's Hospital of Sichuan Province)from January 1 to September 30,2022 were selected as the study objects.According to different surgical methods,the children were divided into preoperative separation group(n=176)and routine operation group(n=170).The degree of penile adhesion,the incidence of adhesion,the time of surgical separation,the rate of postoperative separation and adhesion,the satisfaction of parents on the appearance of penile and wound care,and the operation time of the two groups were observed.Results The degree of intraoperative adhesion in the preoperative separation group was lower than that in the conventional surgery group,and the time of intraoperative adhesion separation was shorter than that in the conventional surgery group,with statistically significant differences(P<0.05);the degree of postoperative adhesion in the preoperative separation group was lower than that in the conventional surgery group,and the proportion of children requiring reoperation for separation was less than that in the conventional surgery group,with statistically significant differences(P<0.05).The operation time of preoperative separation group was shorter than that of conventional operation group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).The parents'satisfaction with the appearance of the penis and wound nursing in the preoperative separation group was higher than that in the conventional surgery group,with statistically significant differences(P<0.05).Conclusions Preseparation of penis glanopanea adhesion in children undergoing circumcision can reduce the incidence and severity of intraoperative and postoperative adhesion,shorten the operative time,and obtain higher parental requirements for penis appearance and nursing satisfaction,without increasing the risk of surgical complications.