摘要
目的总结一次性包皮环切缝合器和包皮去除环在包皮环切术中的操作风险和术后并发症的预防。方法回顾性分析2014年10月—2020年12月在天津市第三中心医院分院行包皮环切术的患者120例,其中使用两种辅助器械行包皮环切术者各60例,分别作为缝合器组和去除环组,比较两组术中操作细节和术后出现的并发症情况,总结使用两种器械分别遇到的问题并提出解决办法,特别是手术操作中的细节处理和防范误操作。结果缝合器组出现术后活动性出血2例(3.33%)、切口部分裂开4例(6.67%);去除环组出现切口部分裂开17例(28.33%)、完全裂开2例(3.33%)、切口感染2例(3.33%)。对于切口裂开,均未缝合,经过常规换药均可愈合。术前采取划线和缝标志线防止包皮去除量不易掌握和系带对合不良。结论使用缝合器术后舒适感强、切口裂开的并发症少而轻,但存在术后活动性出血的危险;使用去除环能避免术后出血,但拆环时疼痛评分及切口裂开比例较高。两种器械都存在包皮切除过多或过少问题,可通过改进加以解决。
Objective Summarize the operation risks of disposable circumcision suture device and circumcision ring in circumcision and the prevention of postoperative complications.Methods A total of 120 patients who underwent circumcision in Tianjing Third Central Hospital Branch from October,2014 to December,2020 were retrospective analyzed.All patients were divided into two groups:suture device group(N=60 cases)and circumcision ring group(N=60 cases).The details of operations and postoperative complications were compared,and the problems encountered when using the two devices were analyzed and solutions were proposed,especially,the detail processing of the operation and misoperation prevention.Results In the suture device group,there were 2 cases(3.33%)of postoperative active bleeding and 4 cases(6.67%)of partial incision dehiscence.In the circumcision ring group,17 cases(28.33%)of the incision were partially dehisced,2 cases(3.33%)were completely dehisced,2 cases(3.33%)of incision were infected.For the dehiscence of the incision,it can be healed without suture,and it can be healed by conventional dressing change.Before the operation,drawing lines and suturing marking lines are used to prevent the amount of foreskin removal and the laceration from being inadequate.Conclusion After using the suture device,the postoperative comfort is strong,and the complications of incision dehiscence are few and light,but there is concern about active bleeding;The circumcision ring can avoid postoperative bleeding to the greatest extent,but the pain score is high when the ring is removed,and the proportion of incision dehiscence is high.Both devices have the problems of too much or too little circumcision,but they can be solved by improvement.
作者
刘杰
姜博
宁刚
LIU Jie;JIANG Bo;NING Gang(Department of Urology,Tianjin Third Central Hospital Branch,Tianjin 300250,China)
出处
《中国实用乡村医生杂志》
2021年第10期49-52,共4页
Chinese Practical Journal of Rural Doctor
关键词
包皮环切术
一次性包皮缝合器
包皮去除环
操作细节
Circumcision
Disposable Circumcision Suture Device
Prepuce-resecting Loop
Operation Details
