2种包皮环切器械治疗儿童包茎的疗效比较

Clinical comparison between two methods of circumcision with instrument in children with phimosis

目的:将一次性包皮环切缝合器和内置式商环包皮环切吻合器应用于儿童包茎,对其临床疗效进行比较。方法:将我院2016年1月~2017年8月采用2种术式治疗的312例儿童包茎患儿(年龄5~12岁)随机分为两组,一组采用一次性包皮环切缝合器行包皮环切(缝合器组,n=154例),另一组采用内置式商环包皮环切吻合器行包皮环切(吻合器组,n=158),分别从手术时间、术后疼痛评分、切口愈合时间、术后并发症、外观满意度等方面对两组进行比较。结果:缝合器组的手术时间为(9.36±1.58)min,术后疼痛评分为(2.23±0.34)分,平均切口愈合时间为(10.96±2.63)d,并发症发生率为11.7%,外观满意度为97.4%;吻合器组手术时间为(6.43±1.38)min,术后疼痛评分为(4.32±0.75)分,平均切口愈合时间为(19.1±3.8)d,并发症发生率为5.1%,外观满意度为97.5%。缝合器组术后疼痛较轻,切口愈合时间较短(P<0.05);吻合器组手术时间较短,并发症发生率更低(P<0.05)。两组外观满意度比较差异无统计学意义(P>0.05)。结论:2种微创包皮环切术式均可以快速有效地治疗儿童包茎。虽然缝合器法术后恢复快及痛苦小,但是吻合器法安全性更高,更加适合于儿童。

Objective:To compare the clinical efficacy between two instruments for circumcision in children with phimosis.Method:A total of 312 children with phimosis were randomly divided into two groups.One group(154 cases)received circumcision with disposable circumcision suture device(DCSD group),another group(158 cases)received circumcision with disposable circumcision anastomat(DCA group).The operation duration,pain score after surgery,time for wound healing,rate of postoperative complications and rate of satisfaction with postoperative appearance were compared between two groups.Result:The operation duration,pain score after surgery,time for wound healing,rate of postoperative complications,rate of satisfaction with postoperative appearance were(9.36±1.58)min,(2.23±0.34)scores,(10.96±2.63)days,11.7%and 97.4%,respectively,in DCSD group,as compared with(6.43±1.38)min,(4.32±0.75)scores,(19.1±3.8)days,5.1%and 97.5%in DCA group.Compared with DCSD group,the DCA group had a greater pain score after surgery and longer time for wound healing,but a shorter operation time and less rate of postoperative complications(P<0.05).However,there was no statistical difference between the two groups concerning rate of satisfaction with postoperative appearance(P>0.05).Conclusion:Both DCSD and DCA are effective approaches to circumcision in children with phimosis.Although DCSD group has a more rapid recovery and less suffering,DCA is more secure and worthy of being popularized in children.