河北医科大学学报

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Snodgrass尿道成形术治疗远端尿道下裂

  

  1. 1.河北医科大学第二医院泌尿外科,河北 石家庄 050000;2.河北省沧州市人民医院医专院区肝胆胰外科,河北 沧州 061000
  • 出版日期:2016-08-25 发布日期:2016-09-01
  • 作者简介:齐进春( 1979- ),男,河北玉田人,河北医科大学 第二医院副主任医师,医学硕士,从事泌尿外科疾病诊治研究。

Sondgrass urethroplasty treatment of children with distal shaft hypospadias#br#

  1. 1.Department of Urology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China;
    2.Department of Hepatobiliary and Pancreatic Surgery, Medical College Hospital of
    Cangzhou People's Hospita, Hebei Province, Cangzhou 061000, China
  • Online:2016-08-25 Published:2016-09-01

摘要: [摘要] 目的 观察 Snodgrass 尿道成形术治疗远端尿道下裂的疗效及并发症,为远端尿道下裂治疗提供依
据。方法 选取远端型尿道下裂患者 128 例,均采取 Snodgrass 尿道成形术,术后随访 6 个月以上,总结分析临床效
果。结果 128 例患者中手术成功 101 例,成功率 78.9% 。发生尿道瘘 13 例(位于冠状沟处 9 例,位于阴茎体 4
例),发生率 10.2% ,经 6 个月后 1~2 次尿道瘘修补术成功修复。出现尿道狭窄 9 例,经 2~6 个月尿道扩张成功治
疗 8 例,随访 6 个月以上未再次出现尿道狭窄,尿道完全闭锁 1 例,尿道扩张不能顺利通过,予以尿道劈开,重建尿
道板,半年后再次行 Snodgrass 术成功治愈。出现带管期间的泌尿系感染 3 例,予以早期拔管,辅以静脉滴注敏感
抗生素后治愈。术后出现阴茎头裂开 2 例,尿道外口位于冠状沟处,无狭窄,经与患儿家长充分沟通后,暂不行手
术矫治,视患儿阴茎及尿道生长发育情况决定是否再次手术。所有患儿均随访 6 个月以上,未再次出现其他不适
及并发症。结论 Snodgrass 尿道成形术治疗远端型尿道下裂,取材容易,操作简便,成功率较高,并发症发生率低,
值得临床推广。

关键词: 尿道下裂, 尿道成形术, 治疗结果

Abstract: [
Abstract ] Objective Toanalyseanddiscusstheeffectsandcomplicationsofdistalshaft
hypospadiaspatientstotreatmentbySondgrassurethroplasty , andtoprovidethebasisfordistal
shafthypospadiastreatment.Methods Onehundredandtwenty-eightcasesofdistalshaft
hypospadiaspatientswereselected , alltakedSondgrassurethroplasty.After6monthsoffollow-
up
, theclinicalresultswereanalyzed.Results Onehunredandtwenty-eightofthe101patients
hadsuccessfuloperationandthesuccessratewas78.9%.Thereare13patientswithurethral
fistula ( 9caseslocatedincoronarysulcus , 4caseslocatedintheshaftofpenis ), theincidencerate
is10.2%.Allpatientswithurethralfistulawererepairedsuccessfullyby1-2secondaryurethral
fistularepairafter6months.Urethralstrictureoccurredin9patients.After2-6monthsurethral
expansion , 8casesweresuccessfullyrecovered.Urethralstricturedidnotappearagainafter6
monthsfollow-up.Thereis1casewithurethralatresiacompletely.Urethralexpansioncannot
pass.Bysplittingtheurethraandreconstructingtheurethralplate , thiscasewassuccessfully
curedafterhalfayearwithSnodgrass.Thereare3caseswithurinarytractinfectionduring
intratrachealtube.Bygivingearlyextubationandsupplementedbystaticsensitiveantibiotics , the
patientswerecured.Besides , therewere2casesappearglansdehiscence.Urethralmouthis locatedincoronaryditchplacewithoutstenosis.Afterfullcommunicationwiththeparentsof
children , nottemporarysurgicalcorrection wasused.Whetherusingthesurgeryagain was
decidedbythechildren'spenisandurethralgrowthsituation.Allofthem werefollowedupfor6
monthsorabove , andnootherdiscomfortandcomplicationsappeared.Conclusion Snodgrass
urethroplastytotreatdistalshafthypospadiasiseasytodraw materials , simpletooperate , with
highsuccessrateandlowincidenceofcomplications.Itisworthyofclinicalpromotion.

Key words: hypospadias , urethroplasty , treatmentoutcome