【摘要】：目的通過(guò)與根治性切除術(shù)比較,評(píng)價(jià)陰莖陰囊Paget病局部擴(kuò)大切除術(shù)的療效。方法回顧性分析2010年11月—2015年8月收治并符合選擇標(biāo)準(zhǔn)的41例陰莖陰囊Paget病患者臨床資料,其中14例采用局部擴(kuò)大切除術(shù)(A組),27例采用根治性切除術(shù)(B組)。兩組患者年齡、病程、病損部位等一般資料比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。記錄并比較兩組復(fù)發(fā)率、手術(shù)時(shí)間、術(shù)中快速冰凍病理檢查次數(shù)、術(shù)后住院時(shí)間、創(chuàng)面愈合分級(jí)、患者功能及外觀自評(píng)滿意度評(píng)分。結(jié)果與B組比較,A組手術(shù)時(shí)間、術(shù)后住院時(shí)間均顯著縮短,術(shù)中快速冰凍病理檢查次數(shù)減少,比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者均獲隨訪,A組隨訪時(shí)間為13~67個(gè)月,平均35.5個(gè)月;B組11~70個(gè)月,平均38.8個(gè)月。A組創(chuàng)面甲級(jí)愈合11例、乙級(jí)愈合2例、丙級(jí)愈合1例,B組分別為12、7、8例,兩組比較差異有統(tǒng)計(jì)學(xué)意義(Z= 2.102,P=0.036)。術(shù)后5年內(nèi)A組復(fù)發(fā)4例(28.6%),B組復(fù)發(fā)6例(22.2%),比較差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.202,P=0.654)。末次隨訪時(shí),A組患者外觀及功能自評(píng)滿意度評(píng)分顯著高于B組,比較差異有統(tǒng)計(jì)學(xué)意義(t= 2.810,P=0.008)。結(jié)論陰莖陰囊Paget病進(jìn)展緩慢,預(yù)后良好,局部擴(kuò)大切除術(shù)可有效去除癥狀,降低老年患者圍手術(shù)期風(fēng)險(xiǎn),且術(shù)后復(fù)發(fā)率較根治性切除術(shù)未明顯升高。
[Abstract]:Objective to evaluate the effect of local extended excision of Paget's disease of penis and scrotum by comparing with radical excision. Methods the clinical data of 41 patients with Paget's disease of penis and scrotum admitted from November 2010 to August 2015 were retrospectively analyzed. Among them, 14 cases were treated with local extended excision (group A) and 27 cases with radical resection (group B). There was no significant difference between the two groups in age, course of disease, lesion location and other general data (P0.05). The recurrence rate, operation time, the times of intraoperative frozen pathological examination, postoperative hospitalization time, wound healing grade, self-evaluation satisfaction score of patients' function and appearance were recorded and compared between the two groups. Results compared with group B, the operation time and postoperative hospitalization time of group A were significantly shortened, and the number of intraoperative rapid frozen pathological examination was decreased, the difference was statistically significant (P0.05). Two groups of patients were followed up. Group A was followed up for 13 ~ 67 months with an average of 35.5 months. There were 11 cases of grade A wound healing, 2 cases of grade B healing, 1 case of grade C healing in group B and 8 cases in group B, respectively. The difference between the two groups was statistically significant (Z = 2.102). Within 5 years after operation, 4 cases (28.6%) recurred in), B group (22.2%), there was no significant difference between them (蠂 ~ 2 / 0.202 P ~ (0.654). At the last follow-up, the scores of self-evaluation satisfaction of appearance and function in group A were significantly higher than those in group B (t = 2.810p 0.008). Conclusion Paget's disease of penis scrotum develops slowly and has a good prognosis. Extended local excision can effectively remove symptoms and reduce perioperative risk in elderly patients, and the recurrence rate is not significantly higher than that of radical excision.
【作者單位】： 四川大學(xué)華西醫(yī)院美容整形-燒傷外科;
【分類號(hào)】：R699.8

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