管哲明, 刘传阳, 刘青, 刘永东, 胡强. 尿道板纵切卷管尿道成形术和横形带蒂岛状包皮皮瓣尿道成形术治疗小儿中后位尿道下裂的疗效比较[J]. 解放军医学院学报, 2018, 39(9): 782-786. DOI: 10.3969/j.issn.2095-5227.2018.09.011
引用本文: 管哲明, 刘传阳, 刘青, 刘永东, 胡强. 尿道板纵切卷管尿道成形术和横形带蒂岛状包皮皮瓣尿道成形术治疗小儿中后位尿道下裂的疗效比较[J]. 解放军医学院学报, 2018, 39(9): 782-786. DOI: 10.3969/j.issn.2095-5227.2018.09.011
GUAN Zheming, LIU Chuanyang, LIU Qing, LIU Yongdong, HU Qiang. Effect of Snodgrass and Duckett repair for children with middle and posterior hypospadias[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2018, 39(9): 782-786. DOI: 10.3969/j.issn.2095-5227.2018.09.011
Citation: GUAN Zheming, LIU Chuanyang, LIU Qing, LIU Yongdong, HU Qiang. Effect of Snodgrass and Duckett repair for children with middle and posterior hypospadias[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2018, 39(9): 782-786. DOI: 10.3969/j.issn.2095-5227.2018.09.011

尿道板纵切卷管尿道成形术和横形带蒂岛状包皮皮瓣尿道成形术治疗小儿中后位尿道下裂的疗效比较

Effect of Snodgrass and Duckett repair for children with middle and posterior hypospadias

  • 摘要: 目的 研究尿道板纵切卷管尿道成形术(Snodgrass术)和横形带蒂岛状包皮皮瓣尿道成形术(Duckett术)对中后位尿道下裂的治疗效果。 方法 选取2013年3月- 2017年5月潍坊市人民医院收治的158例中后位尿道下裂患儿(平均年龄为3.4岁)为研究对象,手术采用Duckett术式(85例)和Snodgrass术式(73例)。回顾性分析两种术式的术后效果及术后并发症情况,并随访患儿满意度。 结果 对于中位型尿道下裂、尿道板发育好、阴茎曲率< 30°且保留尿道板的阴茎伸直理想的患儿,Snodgrass术式平均手术时间(110.68±23.16) min,明显短于Duckett术式的平均手术时间(151.05±20.16) min(P< 0.05);Sondgrass术式术后并发症发生率15.56%(7/45),低于Duckett术式术后并发症发生率28.89%(13/45)(P< 0.05)。对于后位型尿道下裂,Duckett术治愈率65.00%(26/40),高于Snodgrass术治愈率32.14%(9/28)(P< 0.05),且Duckett术较Snodgrass术满意度更高(P< 0.05)。 结论 近期随访显示,对于中位型尿道下裂、尿道板发育好、保留尿道板的阴茎伸直理想的患儿,Snodgrass术式具有明显优势;对于后位型尿道下裂,Duckett术式较Snodgrass术式更有优势。

     

    Abstract: Objective To study the effect of Snodgrass and Duckett repair for children with middle and posterior hypospadias. Methods One hundred and fifty-eight children with middle and posterior hypospadias (average age of 3.4 years old) were selected from March 2013 to May 2017 in Weifang People's Hospital, 85 cases were treated with Duckett repair and 73 cases with Snodgrass repair. The postoperative outcomes and postoperative complications of the two operative methods were retrospectively analyzed, and the satisfaction degree of the patients was followed up. Results For the children with middle urethral hypospadias, well-developed urethral plate, < 30 degree of curvature of the penis and preserving the ideal extension of urethral plate, the Snodgrass technique had obvious advantages. The mean operating time of Snodgrass was (110.68±23.16) min, which was obviously shorter than that of Duckett(151.05±20.16) min, and the difference was statistically significant (P< 0.05). And the incidence of postoperative complications of Sondgrass was also significantly less than that of Duckett (15.56% vs 28.89%, P< 0.05). For posterior hypospadias, Duckett was more advantageous than Snodgrass with higher cure rate (65.00% vs 32.14%, P< 0.05). Besides, Duckett had higher satisfaction rate than Snodgrass (P< 0.05). Conclusion For the children with middle urethral hypospadias, Snodgrass has obvious advantages for cases with well-developed urethra plate. For posterior hypospadias, Duckett is more advantageous than Snodgrass.

     

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