【摘要】：[目的]探討間斷縫合與連續(xù)縫合兩種不同縫合方式在Snodgrass術(shù)治療前段型、中段型尿道下裂中的應(yīng)用及術(shù)后短期療效的比較。[方法]選取自2015年5月至2016年5月間昆明醫(yī)科大學(xué)第二附屬醫(yī)院泌尿外科無嚴重陰莖下曲的前段、中段型尿道下裂患者42例,年齡2～13歲,按照尿道下裂類型均分為2組:間斷縫合組(21例),其中前段型(尿道開口位于陰莖頭及冠狀溝)13例、中段型(尿道開口位于陰莖體)8例;連續(xù)縫合組(21例),其中前段型12例、中段型9例。兩組患者均實施Snodgrass手術(shù),由我科具有�？瀑Y歷、經(jīng)驗豐富的術(shù)者完成,兩組患者均完成術(shù)后6個月、12個月隨訪。[結(jié)果]兩組術(shù)前一般情況比較,差異無統(tǒng)計學(xué)意義(P0.05);間斷縫合組手術(shù)時間長于連續(xù)縫合。但術(shù)后6個月復(fù)查尿瘺、尿道狹窄等并發(fā)癥發(fā)生例數(shù)、術(shù)后二次手術(shù)實施例數(shù),間斷縫合組明顯少于連續(xù)縫合組,差異有統(tǒng)計學(xué)意義(P0.05)。[結(jié)論]1.在治療前段、中段型尿道下裂不伴有嚴重下曲畸形的病例時,Snodgrass術(shù)可考慮作為首選術(shù)式;2.相比較于連續(xù)縫合方式,采用間斷縫合尿道板的方式會增加手術(shù)時間,但可明顯減少術(shù)后尿瘺、尿道狹窄等并發(fā)癥的發(fā)生,并有效避免二次手術(shù)的幾率;3.兩組患兒術(shù)前術(shù)后CBCL調(diào)查問卷中抑郁因子和多動因子改善明顯,該術(shù)式可減輕患兒及家屬心理負擔(dān),提高患兒生活質(zhì)量。
[Abstract]:[objective] to explore the application of discontinuous suture and continuous suture in the treatment of anterior and middle type hypospadias by Snodgrass. [methods] from May 2015 to May 2016, 42 patients with middle urethral hypospadias, aged from 21 to 13 years, were selected from Urology Department, second affiliated Hospital of Kunming Medical University. According to the type of hypospadias, they were divided into two groups: the discontinuous suture group (21 cases), the anterior segment type (the urethral opening was located in the penis head and the coronal sulcus) in 13 cases, and the middle segment type (the urethral opening was located in the penis body in 8 cases). In the continuous suture group (21 cases), there were 12 cases of anterior segment type and 9 cases of middle segment type. Snodgrass was performed in both groups. The patients in both groups were followed up for 12 months and 6 months after operation. [results] there was no significant difference between the two groups before operation (P0.05), the operation time of discontinuous suture group was longer than that of continuous suture group. But six months after the re-examination of urinary fistula urethral stricture and other complications the number of cases of secondary operation after surgery interrupted suture group was significantly less than continuous suture group the difference was statistically significant (P0.05). [conclusion] 1. In the treatment of patients with anterior and middle hypospadias without severe hypospadias, Snodgrass procedure can be considered as the first choice. 2. Compared with continuous suture, intermittent suture of urethra plate can increase the operation time, but can obviously reduce the occurrence of postoperative complications such as urinary fistula and urethral stricture, and effectively avoid the probability of secondary operation. 3. The depression factor and hyperactivity factor in CBCL questionnaire were improved obviously in both groups, which can reduce the psychological burden and improve the quality of life of the children and their families.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R726.9

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