摘要
目的:观察使用定位切割平面的缝合器式包皮环切术治疗包茎和包皮过长的临床疗效。方法:250例患者随机分为两组,观察组123例,采用定位切割平面的缝合器式包皮环切术治疗;对照组127例,采用常规缝合器式包皮环切术治疗,观察两种包皮环切手术的手术时间、术中出血、系带对合、术后瘀斑、术后外观满意程度,并进行统计分析。结果:观察组和对照组手术时间分别为(7.17±1.42)min和(4.48±1.18)min;术中系带处出血分别为4.1%(5/123)和15.0%(19/127),系带对合不良分别为0.8%(1/123)和26.8%(34/127),术后瘀斑分别为21.1%(26/123)和41.7%(53/127),术后外观满意程度分别为98.4%(121/123)和92.9%(118/127),以上差异均具有统计学意义(P<0.05);观察组和对照组术中非系带处出血分别为1.6%(2/123)和4.7%(6/127),差异无统计学意义(P=0.164)。结论:定位切割平面的缝合器式包皮环切术可以在术中实现理想的切割,保证系带的准确对合,减少术中出血,提高术后外观满意度,临床效果良好,有推广应用价值。
Objective: To investigate the clinical effects of circumcision by surgical plane positioning with a disposable circumcision suture device in the treatment of phimosis and redundant prepuce. Methods: From September 2016 to June 2017,we treated250 patients with phimosis or redundant prepuce,127 by conventional circumcision( the control group) and the other 123 by surgical plane positioning with a disposable circumcision suture device( the observation group). We compared the operation time,intra-operative bleeding,preputial frenulum alignment,postoperative ecchymosis,and postoperative penile appearance between the two groups of patients. Results: Compared with the controls,the patients in the observation group showed significantly longer operation time( [4. 48 ± 1. 18]vs [7. 17 ± 1. 42]min,P < 0. 05),lower rates of intra-operative frenulum bleeding( 15. 0% [19/127]vs 4. 1%[5/123],P < 0. 05) and frenulum misalignment( 26. 8% [34/127]vs 0. 8% [1/123],P < 0. 05),higher incidence of postoperative ecchymosis( 41. 7% [53/127] vs 21. 1% [26/123],P < 0. 05),and higher satisfaction of the patients with the postoperative penile appearance( 92. 9% [18/127] vs 98. 4% [121/123],P < 0. 05). However,no statistically significant difference was found between the control and observation groups in intra-operative non-frenulum bleeding( 4. 7% [6/127] vs 1. 6% [2/123 ],P = 0.164). Conclusion: Circumcision by surgical plane positioning with a disposable circumcision suture device can effectively avoid preputial frenulum misalignment,reduce intra-operative bleeding,and improve postoperative penile appearance.
引文
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