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目的比较长隧道分期尿道成形术与传统分期尿道成形术在男性重型尿道下裂的治疗效果。方法 2010-2013年中山大学附属第一医院小儿外科收治重型尿道下裂患者82例,其中21例行长隧道分期术式,余61例行传统分期术式,比较两组手术时间、出血量、术后患者生殖器外观满意度、尿瘘发生率、尿道狭窄发生率、尿道憩室发生率、阴囊分裂纠正率以及阴茎阴囊纠正率。结果长隧道组二期手术时间(70±20)min低于传统组(110±25)min,差异有统计学意义(P<0.05);术后随访长隧道组生殖器外观满意率(95.2%)及阴茎阴囊倒位纠正率(92.3%),高于传统组生殖器外观满意率(78.6%)及阴茎阴囊倒位纠正率(0.0%),差异有统计学意义(P<0.05);长隧道组尿瘘发生率(0.0%)低于传统组(13.1%),差异有统计学意义(P<0.05)。结论长隧道分期尿道成形术手术时间短,大大降低尿瘘的发生,可同时纠正阴囊分裂及阴茎阴囊倒位,生殖器外观改善满意,疗效优于传统术式。
Objective To compare the therapeutic effect of long-term urethral staging urethroplasty and traditional urethroplasty in male patients with severe hypospadias. Methods A total of 82 patients with severe hypospadias were enrolled in Department of Pediatric Surgery, the First Affiliated Hospital of Sun Yat-sen University from 2010 to 2013. Twenty-one of them were staged by the long tunnel and 61 were performed conventional staging. The operation time, blood loss, Postoperative genital appearance satisfaction, the incidence of urinary fistula, the incidence of urethral stricture, urethral diverticulum incidence, correction rate of scrotal sclera and penis scrotum correction rate. Results The length of the second tunnel in the long tunnel group was significantly lower (70 ± 20) min than that in the conventional group (110 ± 25) min, with a significant difference (P <0.05) (92.3%) were higher than those of the traditional group (78.6%) and the penis scrotum (0.0%), the difference was statistically significant (P <0.05). The long tunnel group The incidence of urinary fistula (0.0%) was lower than that of the traditional group (13.1%), the difference was statistically significant (P <0.05). Conclusions Long tunnel staging urethroplasty has a short operative time and greatly reduces the incidence of urinary fistula. It can correct scrotal sclerosis and penis scrotum inversions at the same time. The genital appearance is improved satisfactorily and the curative effect is better than that of traditional surgical procedures.