国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2011年
8期
537-540
,共4页
尿道下裂%尿瘘%并发症
尿道下裂%尿瘺%併髮癥
뇨도하렬%뇨루%병발증
Hypospadias%Fistula%Complications
目的 研究小儿先天性尿道下裂手术后尿瘘发生的原因,探讨小儿尿道下裂术后尿瘘的修复方法,总结手术经验,提高尿瘘一次修补成功率.方法 收集2001年1月-2011年2月33例小儿尿道下裂尿道成形术后尿瘘的临床资料,平均年龄6.2岁(3～13岁).共38个瘘口,痿口直径小于3 mm的有17个,瘘口直径为3～10mm的有16个,大于10 mm的有5个.分别采用结扎包埋法、Y-V皮瓣覆盖法、瘘口连续内翻缝合法、Thiersch法、Denis-Browne法及"U"形皮瓣多层覆盖法进行尿瘘修复,结果33例患儿一次修复成功30例,随访后排尿正常,阴茎外观满意,成功率为90.9%.结果 小儿尿道下裂手术后发生尿瘘的原因主要有:取材时血管蒂游离不当,致使皮瓣血液供应差;尿液引不通畅,致使缝合创面过早浸泡尿液导致感染;远端尿道狭窄,排尿时尿道内压力过高,致吻合口裂开;缝合材料质量差;技术不成熟.结论 小儿尿道下裂术后尿瘘的修复有多种术式,应根据尿瘘的部位、大小、数量和局部条件选择不同的手术方法.
目的 研究小兒先天性尿道下裂手術後尿瘺髮生的原因,探討小兒尿道下裂術後尿瘺的脩複方法,總結手術經驗,提高尿瘺一次脩補成功率.方法 收集2001年1月-2011年2月33例小兒尿道下裂尿道成形術後尿瘺的臨床資料,平均年齡6.2歲(3～13歲).共38箇瘺口,痿口直徑小于3 mm的有17箇,瘺口直徑為3～10mm的有16箇,大于10 mm的有5箇.分彆採用結扎包埋法、Y-V皮瓣覆蓋法、瘺口連續內翻縫閤法、Thiersch法、Denis-Browne法及"U"形皮瓣多層覆蓋法進行尿瘺脩複,結果33例患兒一次脩複成功30例,隨訪後排尿正常,陰莖外觀滿意,成功率為90.9%.結果 小兒尿道下裂手術後髮生尿瘺的原因主要有:取材時血管蒂遊離不噹,緻使皮瓣血液供應差;尿液引不通暢,緻使縫閤創麵過早浸泡尿液導緻感染;遠耑尿道狹窄,排尿時尿道內壓力過高,緻吻閤口裂開;縫閤材料質量差;技術不成熟.結論 小兒尿道下裂術後尿瘺的脩複有多種術式,應根據尿瘺的部位、大小、數量和跼部條件選擇不同的手術方法.
목적 연구소인선천성뇨도하렬수술후뇨루발생적원인,탐토소인뇨도하렬술후뇨루적수복방법,총결수술경험,제고뇨루일차수보성공솔.방법 수집2001년1월-2011년2월33례소인뇨도하렬뇨도성형술후뇨루적림상자료,평균년령6.2세(3～13세).공38개루구,위구직경소우3 mm적유17개,루구직경위3～10mm적유16개,대우10 mm적유5개.분별채용결찰포매법、Y-V피판복개법、루구련속내번봉합법、Thiersch법、Denis-Browne법급"U"형피판다층복개법진행뇨루수복,결과33례환인일차수복성공30례,수방후배뇨정상,음경외관만의,성공솔위90.9%.결과 소인뇨도하렬수술후발생뇨루적원인주요유:취재시혈관체유리불당,치사피판혈액공응차;뇨액인불통창,치사봉합창면과조침포뇨액도치감염;원단뇨도협착,배뇨시뇨도내압력과고,치문합구렬개;봉합재료질량차;기술불성숙.결론 소인뇨도하렬술후뇨루적수복유다충술식,응근거뇨루적부위、대소、수량화국부조건선택불동적수술방법.
Objective To study the causes of congenital hypospadias fistula and the repair methods,summarize surgical experience,and improve the success rate of fistula repair.Method s From January 2001 to February 2011,33 cases of urinary fistula after hypospadias urethroplasty were collected,the average age being 6.2 years (3 to 13 years).A total of 38 fistula were found,17 with fistula diameter of less than 3 mm,16 with fistula diameter of 3 - 10 mm,5 greater than 10 mm.Ligation embedding method were used,Y-V flap coverage method,a continuous inverted fistula suture,Thiersch method,Denis-Browne method and the "U" shaped flap covering method were used for multi-urinary fistula repair.Among the 33 cases,successful repair was found in 30 cases,with normal urination during flollow- up,good penile appearance,the success rate being 90.9%.Results The causes of hypospadias fistula after surgery in children are:vascularized free when properly drawn,resulting in poor blood supply to the flap; urine drainage was not smooth,resulting in premature suture wounds soaked in urine,causing infection; distal urethral stricture,high pressure within the urethra during urination,causing anastomotic dehiscence; suture materials of poor quality; technical immaturity.Conclusions The repair of urinary fistula after hypospadias in children has a variety of surgical procedures,choice of which should be based on fistula location,size,quantity and local conditions.
