摘要
目的分析分叉尿道海绵体修复对尿道下裂Duckett术患者的冠状沟直径、尿道长度、最大尿流率及并发症的影响。方法选取2017年1月至2020年5月在本院治疗的85例尿道下裂患儿为研究对象,入院后均行Duckett尿道成形术,按照不同修复方式分为观察组(分叉尿道海绵体修复,44例)和对照组(筋膜覆盖修复,41例),比较两组患者的治疗效果及并发症发生情况。结果两组患儿的手术时间、术中出血量、下床时间、住院时间比较,差异均无统计学意义(均P>0.05)。术后,两组患儿的冠状沟直径、重建尿道长度与术前比较,差异均无统计学意义(均P>0.05),而最大尿流率均小于术前(均P<0.05)。术后,两组患儿的冠状沟直径、重建尿道长度比较,差异均无统计学意义(均P>0.05),而观察组的最大尿流率明显大于对照组(P<0.05)。术后1、2、3 d,观察组的儿童疼痛评估量表(FLACC)评分均明显低于对照组(均P<0.05);与术后1 d相比,两组术后2、3 d的FLACC评分均明显升高;与术后2 d相比,两组术后3 d的FLACC评分明显降低,差异均有统计学意义(均P<0.05)。观察组的并发症总发生率明显低于对照组(P<0.05)。结论Duckett术中应用分叉尿道海绵体修复可降低尿道下裂患儿的术后并发症发生率,且对其排尿功能、疼痛的不良影响较小,临床应用前景较好。
Objective To analyze the effect of divergent corpus spongiosum repair on the diameter of coronary sulcus,urethral length and complications in patients undergoing Duckett surgery for hypospadias.Methods A total of 85 patients with hypospadias treated in our hospital from January 2017 to May 2020 were selected as the research subjects.All underwent Duckett surgery after admission.According to different repair methods,the patients were divided into observation group(divergent corpus spongiosum repair,44 cases)and control group(fascia coverage repair,41 cases).Treatments and complication of the two groups were compared.Results There was no significant difference in operation time,intraoperative blood loss,time to get out of bed or hospital stay between the two groups(all P>0.05).After the operation,the diameter of coronary sulcus and the length of reconstructed urethra in the two groups were not significantly different from those before the operation(all P>0.05),while the maximum flow rate was lower than that before the operation(all P<0.05).There was no significant difference in the diameter of coronary sulcus or the length of reconstructed urethra between the two groups(all P>0.05).The maximum flow rate in the observation group was significantly higher than that in the control group(P<0.05).The FLACC scores of the observation group were significantly lower than those of the control group on day 1,day 2 and day 3 after operation(all P<0.05).The FLACC scores of the two groups on day 1,day 3 and day 2 after operation increased in sequence(all P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusions Applying divergent corpus spongiosum repair in Duckett surgery can significantly reduce postoperative complications in patients with hypospadias,with less adverse effects on urinary function and pain.
作者
徐华兵
徐志晓
Xu Huabing;Xu Zhixiao(Department of Urology,Zengdu Hospital of Suizhou City,Suizhou 441300,China)
出处
《国际泌尿系统杂志》
2024年第4期661-665,共5页
International Journal of Urology and Nephrology
