五步法袖套式包皮环切术治疗包皮过长的临床疗效分析
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摘要
目的:介绍自创五步法袖套式包皮环切术的手术方法与效果。方法:2017年1-12月,中国人民解放军总医院第一附属医院泌尿外科为68例18～40岁包皮过长患者行五步法袖套式包皮环切术。五步法袖套式包皮环切术改良的方法主要包括:环形切开包皮内、外板皮肤后,以单层纱布包裹阴茎头部一圈作为保护和支撑;钳夹、提起包皮外板切缘处皮肤,使用小圆刀切、推结合,脱套式分离皮肤和浅筋膜靠近包皮内板切口线,最终环形剥离剩余内板皮肤,充分止血后缝合、包扎。结果:68例患者术中出血均较少,手术时间短,并发症发生率低,所有病例切缘整齐、美观。结论:五步法袖套式包皮环切术,降低了传统袖套状环切术的手术难度,是一种值得推广的新型手术方法。
Objective:To discuss the procedures and effectiveness of self-created "five step" sleeve circumcision.Methods:A total of 68 patients aged 18-40 y with redundant prepuce underwent circumcision by "five step" sleeve circumcision technique in our hospital from January 2017 to December 2017. Under the block anesthesia of penis nerve,two sections of the skin of penis were resected as conventional sleeve circumcision,and the improved method mainly included the use of the sterile gauze to protect the glans and make isolating easier. The degloving anatomical method was used to maintain the superficial fascia of penis efficiently.Results:All patients had less blood loss,shorter operation duration and lower complication rate. The incisions were neatly and well-down.Conclusion:This "five step" sleeve circumcision technique is simple to master,and easy to follow. It is worthy to be wildly applied clinically.
Objective:To discuss the procedures and effectiveness of self-created "five step" sleeve circumcision.Methods:A total of 68 patients aged 18-40 y with redundant prepuce underwent circumcision by "five step" sleeve circumcision technique in our hospital from January 2017 to December 2017. Under the block anesthesia of penis nerve,two sections of the skin of penis were resected as conventional sleeve circumcision,and the improved method mainly included the use of the sterile gauze to protect the glans and make isolating easier. The degloving anatomical method was used to maintain the superficial fascia of penis efficiently.Results:All patients had less blood loss,shorter operation duration and lower complication rate. The incisions were neatly and well-down.Conclusion:This "five step" sleeve circumcision technique is simple to master,and easy to follow. It is worthy to be wildly applied clinically.
引文
[1]KRILL AJ,PALMER LS,PALMER JS.Complications of circumcision.Sci World J,2011,11:2458-2468.
[2]霍仲超,刘刚.包皮环切术的研究进展.中国临床新医学,2016,9(7):655-658.
[3]梅骅.泌尿外科手术学.中华泌尿外科杂志,1999,20(9):534-536.
[4]SHARMA SC,RAISON N,KHAN S,et al.Male circumcision for the prevention of human immunodeficiency virus(HIV)acquisition:a meta-analysis.BJU Int,2018,121(4):515-526.
[5]TOBIAN AA,KACKER S,QUINN TC.Male circumcision:a globally relevant but under-utilized method for the prevention of HIV and other sexually transmitted infections.Annu Rev Med,2014,65:293-306.
[6]黄亮亮,邓军洪,石华,等.包皮环切术对男性HPV感染影响的相关性研究.中华男科学杂志,2018,24(4):327-330.
[7]王华礼,葛玉坤,孙旭东,等.4种包皮环切术临床疗效对比分析.中华男科学杂志,2018,24(2):189-191.
[8]施问国,李淑琴,周伟,等.牵引手法在袖套式包皮环切术中的应用.中华男科学杂志,2009,15(7):658-660.
[9]李靖,朱东川,聂磊.改良袖套式包皮环切术与传统包皮环切术的疗效比较.中国医疗美容,2016,6(3):40-41.
[10]顾本宏,田汝辉,智二磊,等.商环包皮环切术与改良袖套式包皮环切术73例临床疗效比较.中国男科学杂志,2017,31(5):53-56.
[11]赵红旗,米其武,王丹.传统包皮环切术与袖套式包皮环切术疗效对比分析.中国现代药物应用,2018,12(2):20-21.
[12]刘剑毅,林卫,胡晓佳,等.去表皮包皮环切阴茎增粗术临床疗效分析.第三军医大学学报,2012,34(20):2112-2114.
[2]霍仲超,刘刚.包皮环切术的研究进展.中国临床新医学,2016,9(7):655-658.
[3]梅骅.泌尿外科手术学.中华泌尿外科杂志,1999,20(9):534-536.
[4]SHARMA SC,RAISON N,KHAN S,et al.Male circumcision for the prevention of human immunodeficiency virus(HIV)acquisition:a meta-analysis.BJU Int,2018,121(4):515-526.
[5]TOBIAN AA,KACKER S,QUINN TC.Male circumcision:a globally relevant but under-utilized method for the prevention of HIV and other sexually transmitted infections.Annu Rev Med,2014,65:293-306.
[6]黄亮亮,邓军洪,石华,等.包皮环切术对男性HPV感染影响的相关性研究.中华男科学杂志,2018,24(4):327-330.
[7]王华礼,葛玉坤,孙旭东,等.4种包皮环切术临床疗效对比分析.中华男科学杂志,2018,24(2):189-191.
[8]施问国,李淑琴,周伟,等.牵引手法在袖套式包皮环切术中的应用.中华男科学杂志,2009,15(7):658-660.
[9]李靖,朱东川,聂磊.改良袖套式包皮环切术与传统包皮环切术的疗效比较.中国医疗美容,2016,6(3):40-41.
[10]顾本宏,田汝辉,智二磊,等.商环包皮环切术与改良袖套式包皮环切术73例临床疗效比较.中国男科学杂志,2017,31(5):53-56.
[11]赵红旗,米其武,王丹.传统包皮环切术与袖套式包皮环切术疗效对比分析.中国现代药物应用,2018,12(2):20-21.
[12]刘剑毅,林卫,胡晓佳,等.去表皮包皮环切阴茎增粗术临床疗效分析.第三军医大学学报,2012,34(20):2112-2114.