CAJ | 학술논문

目的探讨和总结尿道下裂成形术后发生并发症的原因、发病比例、相应的处理措施及预防方法 .方法 117 例尿道下裂患者进行尿道成形术后产生并发症19 例,年龄为36 个月～24岁,平均为4.6岁.发生并发症的尿道下裂临床分型为阴茎头型10例,阴茎体型5 例,阴茎阴囊型、阴囊型或会阴型等重度尿道下裂4 例.成形尿道长度为1.2～4.4cm,平均为2.6cm.结果术后随访1～3年,总的并发症发生率为15.9%.其中尿道瘘者为11例(57.9%),尿道狭窄4 例(21.1%),尿道憩室1例(5.3%),尿道口退缩1例(5.3%),阴茎弯曲畸形矫正不全1 例(5.3%),阴茎皮肤外观重度不良1 例(5.3%).尿道瘘和尿道狭窄发生率显著高于其他并发症发生率( P<O.05),尿道瘘的发生率显著高于尿道狭窄发生率( p<O.05).结论尿道瘘是尿道下裂成形术后最常见的并发症,尿道狭窄次之.选择适宜的术式,严格精细的手术操作,是减少该类并发症的关键;适宜的切口敷料、恰当的尿液引流方法、支架管放置方法、合理的术后用药和加强护理均有助于减少并发症的发生率.
목적 탐토화총결뇨도하렬성형술후발생병발증적원인、발병비례、상응적처리조시급예방방법 .방법 117 례뇨도하렬환자진행뇨도성형술후산생병발증19 례,년령위36 개월～24세,평균위4.6세.발생병발증적뇨도하렬림상분형위음경두형10례,음경체형5 례,음경음낭형、음낭형혹회음형등중도뇨도하렬4 례.성형뇨도장도위1.2～4.4cm,평균위2.6cm.결과 술후수방1～3년,총적병발증발생솔위15.9%.기중뇨도루자위11례(57.9%),뇨도협착4 례(21.1%),뇨도게실1례(5.3%),뇨도구퇴축1례(5.3%),음경만곡기형교정불전1 례(5.3%),음경피부외관중도불량1 례(5.3%).뇨도루화뇨도협착발생솔현저고우기타병발증발생솔( P<O.05),뇨도루적발생솔현저고우뇨도협착발생솔( p<O.05).결론 뇨도루시뇨도하렬성형술후최상견적병발증,뇨도협착차지.선택괄의적술식,엄격정세적수술조작,시감소해류병발증적관건;괄의적절구부료、흡당적뇨액인류방법 、지가관방치방법 、합리적술후용약화가강호리균유조우감소병발증적발생솔.
Objectives To study and analyze the cauge,rate and treatment for complications of hypospadi - as repair operations.Methods In the past 3 years,there were 19 patients with complications of hypospedias repair for 117 cases single - stage urethmplasty.The ages were from 1.5 to 24 years old,the mean Was 4.6.The classifica - tions were glans of penis 10,body of penis 5,serious hypospedias 4,includingpenoscrota,scrotal andperineal.The lengths of new urethras were from 1.2 to 4.4 cm,the mean was 2.6 cm.Results The rate of complications was 15.9%for 1～3 years following survey.There were urethral fistulas 11 cases(57.9%),urethral strictures 4(21.1%),diverticulumsl(5.3%),withdrawal of meatus 1(5.3%),chordees 1(5.3%),seriouS abnomal apperance of penis 1 cases(5.3%).The rate of urethral fistulas was the first and urethral stricture the second,they were higher than other complications signiflcantly(P<O.05).Conclusions Urethral fistulas was the frequentest compli - cation of urethroplasty for hypospadias.Urethral stricture Was the second.It is important to choose feasible opera - tion method,process carefully,fix with soft dressing,dwelling catheter and inject antibiotics for decreasing the complications of the hypospadias urethmplasty.